Congo has confirmed that 17 people have died of the http://www.mirror.co.uk/all-about/ebola-virus" rel="nofollow - Ebola virus after a new outbreak flared up.

The
revelation has caused concern just a few years after it swept across
West Africa between 2014 and 2016, killing at least 11,000 people

Jean
Jack Muyembe, head of the national institute for biological research in
the Democratic Republic of Congo, confirmed the news today.

It
is the ninth time Ebola has been recorded in the Democratic Republic of
Congo, whose eastern Ebola river gave the deadly virus its name when it
was discovered there in the 1970s.

The http://www.mirror.co.uk/all-about/world-health-organisation" rel="nofollow - World Health Organisation said in a statement: "This is DRC’s ninth outbreak of Ebola since the discovery of the virus in the country in 1976.

"In the past five weeks, there have been 21 suspected viral
haemorrhagic fever in and around the iIkoko Iponge, including 17
deaths."

Ebola has fatality rates of up to 90% and early symptoms include fever fatigue, muscle pain, headache and http://www.mirror.co.uk/lifestyle/health/how-rid-sore-throat-quickly-9585923" rel="nofollow - sore throat .

This
is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney
and liver function and both internal and external bleeding.

The
latest incidence of the disease comes less than a year after the central
African country's last outbreak, in which eight people were infected of
whom four died.

Congo's vast, remote geography gives it an advantage, as outbreaks are often localised and relatively easy to isolate.

In
west Africa, an Ebola outbreak that ended two years ago killed more
than 11,300 people and infected some 28,600 as it rolled through Guinea,
Sierra Leone and Liberia before finally being contained.

It was the largest and most complex Ebola outbreak since the virus was first discovered in 1976.

Ebola is believed to be spread over long distances by bats, which can
host the virus without dying, as it infects other animals it shares
trees with such as monkeys. It often spreads to humans via infected
bushmeat.

In March last year, Sierra Leone was finally declared
Ebola-free, like its neighbours, but the disease stripped already poor
families of breadwinners and left countries with thousands of orphans.

With many forced to take in the orphans of their relatives and neighbours, they simply cannot cope.

British
nurse Pauline Cafferkey, who made headlines around the world after she
contracted the disease while working to treat the sick, made her http://www.mirror.co.uk/news/world-news/ebola-nurse-pauline-cafferkey-returns-10531460" rel="nofollow - first brave return to Sierra Leone this time last year.

The Scot – who http://www.mirror.co.uk/news/uk-news/ebola-nurse-pauline-cafferkey-tests-8993942" rel="nofollow - battled Ebola not once but an unheard-of twice , coming close to death both times – put aside her past three hellish years http://www.mirror.co.uk/news/uk-news/ebola-nurse-says-going-back-10213705" rel="nofollow - to return and see how the country she tried to help in 2014 is recovering post-Ebola.

Horror
photos show what is now the ghost town of Lunsar with its crumbling
homes and eerie, echoing rooms, which left Pauline stunned.

“I didn’t expect to see this so long afterwards,” she whispers. “The stigma must be keeping people away. They’re afraid.

“This
is the side of Ebola I did not see when I worked in the treatment
centre. Then, I couldn’t go into the community. I can imagine it now, a
family living here and what they suffered.

“I can see men carrying the dead out in body bags. This is very real, very human. These are the people I couldn’t save.”

Hey Ebola is really really nasty. I hope it never gets past Africa. If the people in Africa will just learn how to avoid spreading this disease it would be great but they are not educated or are too stuck to their traditions of cleaning the bodies of the dead. It spreads. Ebola just a bad actor.

Rear Adm. Tim Ziemer, the head of global health security on the White House’s National Security Council, left the https://www.huffingtonpost.com/topic/trump-administration/" rel="nofollow - Trump administration on Tuesday. The news was announced one day after an https://www.huffingtonpost.com/entry/who-ebola-outbreak-democratic-republic-of-congo_us_5af1d563e4b0ab5c3d6a9285" rel="nofollow - Ebola outbreak was declared in the Democratic Republic of the Congo.

The departure comes amid a reshuffling of the NSC under newly named national security adviser John Bolton, which includes a change in organizational structure that eliminates the office Ziemer led. Ziemer’s staff has been placed under other NSC departments.

-------------CRS, DrPH

Posted By: Technophobe
Date Posted: May 10 2018 at 7:55am

[Well, against all expectations, he seems to be doing ok with north Korea.But as far as Iran and global health security go, he seems to be failing draamatically.]

Ebola Returns Just as Trump Asks to Rescind Ebola Funds

Fortunately, the new outbreak is happening in the DRC, a country well versed in fighting the dreaded virus.

Ebola is back.

The infamous viral disease first made itself known to the world in 1976, in https://www.theatlantic.com/science/archive/2017/12/forty-years-later-some-survivors-of-the-first-ebola-outbreak-are-still-immune/548339/" rel="nofollow - a small village called Yambuku
in the Democratic Republic of the Congo. Now, 42 years later, Ebola is
causing another outbreak in the DRC—the ninth in the country’s history.

The
new outbreak has hit the town of Bikoro in the northwestern part of the
country. The nearby iIkoko Iponge health facility—picture a small
building with no electricity and limited supplies—reported 21 suspected
cases over the past 5 weeks. Seventeen have died, but it’s not clear how
many of these people actually had Ebola. So far, just two cases were
actually positive for the virus in laboratory tests, out of five samples
that were sent to the National Institute of Biomedical Research (INRB)
in Kinshasa.

Some might wonder why lab tests are necessary. Isn’t
Ebola so horrific that a case would be obvious? Actually: no. Ebola’s
symptoms have been grossly exaggerated by The Hot Zone and
other popular accounts. In reality, it is often indistinguishable from
more common illnesses like malaria or typhoid. Only a minority of
patients hemorrhage, and most do so lightly. The virus doesn’t liquefy
its victims’ organs, nor cause blood to gush from every orifice. When
Ebola kills, it’s usually through extreme dehydration.

For now, there is no reason for
alarm. Despite the unprecedentedly large Ebola epidemic in West Africa,
which infected 28,000 people and killed 11,000 between 2014 and 2016,
most Ebola outbreaks have been small and contained affairs. Several have
involved handfuls of cases. Already, experts from the World Health
Organization, Doctors Without Borders, and local Congolese health
institutes have traveled to Bikoro. The CDC is supporting local public
health partners, and the http://www.who.int/news-room/detail/08-05-2018-new-ebola-outbreak-declared-in-democratic-republic-of-the-congo" rel="nofollow - WHO is planning
to deploy more personnel and protective equipment, and has released $1
million from a contingency fund to help stop the outbreak.

A sense
of geography is helpful. Look at the back of your right hand. Stick
your thumb out and begin curling your fingertips in, stopping short of
making a fist. That’s the DRC—a country one-quarter the size of the
United States. The capital city, Kinshasa, sits on the knuckle of your
thumb. Bikoro, the site of the new outbreak, is on the base of your
index finger. Yambuku, the site of the first 1976 outbreak, is on your
middle finger. Kikwit, where the next major one happened in 1995, is at
the base of your thumb. That was the outbreak, documented by camera
crews and chronicled by https://www.vanityfair.com/news/1995/08/ebola-africa-outbreak" rel="nofollow - Laurie Garrett in Vanity Fair , which helped catapult Ebola to global infamy.

Related Stories

Look at your hand-map again. Most of it is smothered
by inaccessible forest, with just 1,700 miles of paved road. The
remoteness of this terrain made it easier to control outbreaks like the
most recent one, which https://www.theatlantic.com/science/archive/2017/05/a-new-ebola-outbreak-in-the-democratic-republic-of-congo/526506/" rel="nofollow - hit the Likati health zone in 2017 . It was contained https://www.theatlantic.com/science/archive/2017/07/how-the-democratic-republic-of-congo-beat-ebola-in-42-days/532590/" rel="nofollow - within just 42 days , after just eight suspected cases and four deaths. The DRC and its partners are now looking to repeat that success in Bikoro.

It
could be more challenging. Unlike Likati, Bikoro lies close to the
Congo River—a major trade route—and close to the border with the
neighboring Republic of the Congo. These connections increase the risk
that the outbreak will spread. Then again, it also makes it easier to
mount a response.

The DRC has become very good at controlling
Ebola. The INRB in Kinshasa is more than capable of doing diagnostic
tests without having to ship samples out to the United States. Its
director, Jean-Jacques Muyembe Tamfum, was the first scientist to
encounter Ebola at a time when he was the DRC’s only virologist, and has
been involved in every outbreak response since. He and his colleagues
have also trained a crack-team of researchers and disease detectives.
“We’re advanced in public health,” said Gisèle Mvumbi, a CDC-trained
Congolese epidemiologist at the INRB, whom I met when I visited the DRC
earlier this year. “If you compare us with Europe or the United States,
eh, but here in Africa, we are high. We have experience.”

The
country excels at spotting diseases early. In the wake of the Kikwit
outbreak, scientists like Muyembe and Emile Okitolonda, who leads the
Kinshasa School of Public Health, trained medical staff in all of the
country’s 500-plus health zones to report potential symptoms. Now, even
traditional healers and pastors know to do this. “Here, we have a
surveillance system that works,” Okitolonda told me when I met him in
the DRC. “Here, nurses know that if they see a suspected case, they
report it.”

They might increasingly have cause to
do so. “The last outbreak occurred approximately at the same time of
year, and it appears that these outbreaks are occurring with greater
frequency,” says http://www.ph.ucla.edu/epi/faculty/rimoin/rimoin.html" rel="nofollow - Anne Rimoin
from UCLA, who has worked in the Congo for 16 years. That could be
because the Congolese are getting better at detecting the disease, “but
there is some evidence that this outbreak appears to have been
smoldering for a few months,” Rimoin adds. “Perhaps the ecology is
changing, and it has something to do with the reservoir species.” She
means the animals that harbor the Ebola virus—bats are likely
candidates, but the exact species is still a mystery.

“More
information is needed on the potential introduction of disease into the
human population or whether animal die-offs have been reported,” says
Rebecca Martin, Director of CDC’s Center for Global Health. Her team and
others are working to support studies of the disease’s ecology as a
priority.

The DRC’s main challenge is its lack of resources. Sure,
they can detect Ebola cases quickly, but someone then has to
investigate, usually without suits, masks, or even gloves. Such
equipment was distributed after the Kikwit epidemic, but Okitolonda told
me that within five years, they had all been used up. “It’ll be the
same story in West Africa,” he lamented, now that the catastrophic
outbreak of 2014 is over. “Resources will disappear and people will
forget.”

The United States is already forgetting. Just as news of the Ebola outbreak broke, Donald Trump asked Congress to https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-protecting-american-taxpayer-dollars/" rel="nofollow - rescind $252 million
that had been put aside to deal with Ebola, as part of a broader move
to cut down on “excessive spending.” That pot of money is the leftover
from a $5.4 billion sum that Congress appropriated for dealing with the
West African Ebola epidemic in 2015.

That epidemic ended two years
ago, but “having some money left over was intentional,” says Ron Klain,
the former Ebola czar. It allows USAID to quickly deploy responders to
the site of a future outbreak, to prevent it from metastasizing into an
international disaster. It is not, as the Trump administration suggests,
an example of “irresponsible federal spending.” Quite the opposite:
It’s a savvy investment, since epidemics are always more expensive to
deal with once they rage out of control.

Congress has https://www.vox.com/policy-and-politics/2018/5/8/17316126/rescission-request-omb-trump-fiscal-budget" rel="nofollow - 45 days from the time of Trump’s request
to act, during which time the $252 million is frozen. If they vote it
down, or simply ignore it, the funds will be spent as intended. But “if
Congress accepts Trump’s proposal, USAID will have no funding for a
response when the next crisis comes,” says Klain, “and it will have to
wait until Congress passes new funding, or diverts funds from some
other, then-existing disaster response.”

11 additional cases of hemorrhagic fever in Congo including 1 death

By Susan Scutti, CNN

Updated 0402 GMT (1202 HKT) May 11, 201

(CNN)Eleven
new cases of hemorrhagic fever, including one death, have been reported
since Tuesday in the Democratic Republic of Congo, Minister of Health
Dr. Oly Ilunga said Thursday in Kinshasa. Two of those cases are
confirmed to be Ebola. Lab results are pending on the other nine cases
which are suspected to be Ebola.

Ebola
virus disease, which most commonly affects people and nonhuman primates
such as monkeys, gorillas and chimpanzees, is caused by one of five
Ebola viruses. On average, about 50% of people who become ill with Ebola
die.

The new outbreak was announced Tuesday. Sickness is occurring in the
Bikoro health zone, 400 kilometers (about 250 miles) from Mbandaka, the
capital of Equator province.

The World Health Organization http://www.who.int/emergencies/crises/cod/drc-donor-alert-ebola-10may2018.pdf?ua=1" rel="nofollow - reported Thursday
that 27 total cases of fever with hemorrhagic symptoms were recorded in
the Bikoro region between April 4 and May 5, including 17 deaths. Of
these total cases, two tested positive for Ebola virus disease,
according to the WHO.

The risk to
public health is assessed as high at the local level, moderate at the
regional level and low at the global level, according to the WHO.

The virus is transmitted to people from wild animals and spreads in the
human population through human-to-human transmission. The affected area
in Bikoro is remote, with limited communication and poor transportation
infrastructure, the WHO said. Bikoro has a population of about 163,000
spread over an area of approximately 1,075 square kilometers (415 square
miles).

On Tuesday, Ilunga requested support to
strengthen the response to this outbreak. The ministry and the WHO have
developed a plan to respond to the outbreak over the next three months.
The full extent of the outbreak is not known, according to the WHO, and
the location poses significant logistical challenges.

Three
health care professionals are among the confirmed cases, Ilunga said:
"As health professionals are the first actors in the government's
response to Ebola, this situation is of concern to us and requires a
response that is all the more immediate and energetic."

Ebola is
endemic to the Democratic Republic of Congo, and this is the nation's
ninth outbreak of Ebola virus disease since the discovery of the virus
in the country in 1976. The last outbreak occurred there in 2017 in the
northern Bas Uele province. That outbreak was quickly contained due to
joint efforts by the government, the WHO and other partners.

West Africa experienced the http://www.who.int/csr/disease/ebola/en/" rel="nofollow - largest recorded outbreak of Ebola
over a two-year period beginning in March 2014; a total of 28,616
confirmed, probable and suspected cases were reported in Guinea, Liberia
and Sierra Leone, with 11,310 deaths, according to the WHO.

Correction: A previous version of this story incorrectly stated the new cases and death as confirmed rather than suspected.

The
top White House official responsible for leading the U.S. response in
the event of a deadly pandemic has left the administration, and the
global health security team he oversaw has been disbanded under a
reorganization by national security adviser John Bolton.

The
abrupt departure of Rear Adm. Timothy Ziemer from the National Security
Council means no senior administration official is now focused solely
on global health security. Ziemer’s departure, along with the breakup of
his team, comes at a time when many experts say the country is https://www.washingtonpost.com/news/to-your-health/wp/2018/04/27/bill-gates-calls-on-u-s-to-lead-fight-against-a-pandemic-that-could-kill-millions/?utm_term=.e861b54cdaeb" rel="nofollow - already underprepared for the increasing risks of a https://www.washingtonpost.com/national/health-science/the-trump-administration-is-ill-prepared-for-a-global-pandemic/2017/04/08/59605bc6-1a49-11e7-9887-1a5314b56a08_story.html?utm_term=.6b7fb71a6b57" rel="nofollow - pandemic or bioterrorism attack.

Ziemer’s last day was Tuesday, the same day a https://www.washingtonpost.com/world/africa/congo-health-ministry-confirms-2-cases-of-ebola/2018/05/08/41429d30-52db-11e8-a6d4-ca1d035642ce_story.html?utm_term=.cf7c1f804be3" rel="nofollow - new Ebola outbreak was declared in Congo. He is not being replaced.

Pandemic preparedness and https://www.washingtonpost.com/news/to-your-health/wp/2018/02/01/cdc-to-cut-by-80-percent-efforts-to-prevent-global-disease-outbreak/?utm_term=.99e90744bb7c" rel="nofollow - global health security are
issues that require government-wide responses, experts say, as well as
the leadership of a high-ranking official within the White House who is
assigned only this role.

“Health security is
very fragmented, with many different agencies,” said J. Stephen
Morrison, senior vice president at the Center for Strategic and
International Studies. “It means coordination and direction from the
White House is terribly important. ”

The
personnel changes, which Morrison and others characterize as a
downgrading of global health security, are part of Bolton’s previously
announced plans to streamline the NSC. Two members of Ziemer's team have
been merged into a unit in charge of weapons of mass destruction, and
another official's position is now part of a unit responsible for
international organizations. White House homeland security adviser https://www.washingtonpost.com/politics/white-house-homeland-security-adviser-resigns-amid-continued-turnover-in-trump-administration/2018/04/10/15db518a-3ccb-11e8-a7d1-e4efec6389f0_story.html?utm_term=.2d2315c28d3a" rel="nofollow - Tom Bossert ,
who had called for a comprehensive biodefense strategy against
pandemics and biological attacks, is out completely. He left the day
after Bolton took over last month.

NSC spokesman
Robert Palladino said Wednesday the administration “remains committed
to global health, global health security and biodefense, and will
continue to address these issues with the same resolve under the new
structure.”

Another administration official, who
spoke on the condition of anonymity because he was not authorized to
discuss the issue publicly, acknowledged it was only one of many
administration priorities. “In a world of limited resources, you have to
pick and choose,” he said. “We lost a little bit of the leadership, but
the expertise remains.”

Ziemer
is a well-respected public health leader who was considered highly
effective leading the President’s Malaria Initiative under George W.
Bush and Barack Obama before joining the NSC last year. While Palladino
said he left “on the warmest terms,” an individual familiar with the
specifics behind the reorganization said “he was basically pushed out.
He struggled to preserve himself and the integrity of his team, and he
failed.”

His exit comes against the backdrop of
other administration actions critics say have weakened health security
preparedness, including dwindling financing for early preventive action
against infectious disease threats abroad.

The
new Ebola outbreak is in northwest Congo. Only two cases have been
confirmed, but the World Health Organization reported Thursday another
30 probable and suspected cases of the deadly hemorrhagic fever. Of
those, 18 already have died.

Congolese and
international health officials say they hope to control the outbreak
quickly, but some health officials worry about its potential to become
more serious and spread because of its location in a town upriver from
the densely populated capital of Kinshasa.

This week, the administration released a https://www.washingtonpost.com/business/economy/trump-calls-on-congress-to-pull-back-15-billion-in-spending-including-on-childrens-health-insurance-program/2018/05/07/9427de18-5216-11e8-a551-5b648abe29ef_story.html?utm_term=.d3d190c66a9e" rel="nofollow - list of $15 billion in spending cuts it
wants Congress to approve. Among the targets is $252 million in unused
funds remaining from the 2014-2015 Ebola epidemic in West Africa that
killed more than 11,000 people, far exceeding the combined total cases
reported in about 20 previous outbreaks since the 1970s.

The
White House proposal “is threatening to claw back funding whose precise
purpose is to help the United States be able to respond quickly in the
event of a crisis,” said Carolyn Reynolds, a vice president at PATH, a
global health technology nonprofit.

Collectively,
warns Jeremy Konyndyk, who led foreign disaster assistance at the U.S.
Agency for International Development during the Obama administration,
“What this all adds up to is a potentially really concerning rollback of
progress on U.S. health security preparedness.”

“It
seems to actively unlearn the lessons we learned through very hard
experience over the last 15 years,” said Konyndyk, now a senior policy
fellow at the Center for Global Development. “These moves make us
materially less safe. It’s inexplicable.”

The
day before news of Ziemer’s exit became public, one of the officials on
his team, Luciana Borio, director of medical and biodefense
preparedness at the NSC, spoke at a symposium at Emory University to
mark the 100th anniversary of the https://www.washingtonpost.com/news/retropolis/wp/2018/01/27/the-flu-can-kill-tens-of-millions-of-people-in-1918-thats-exactly-what-it-did/?utm_term=.2cf86c8371cb" rel="nofollow - 1918 influenza pandemic . That event killed an estimated 50 million to 100 million people worldwide.

“The
threat of pandemic flu is the number one health security concern,” she
told the audience. “Are we ready to respond? I fear the answer is no.”

Health officials are preparing for the 'worst' Ebola
outbreak yet: Warning comes days after the first death was confirmed in
the Democratic Republic of Congo

Published: 12:58, 11 May 2018 | Updated: 13:03, 11 May 2018

Peter
Salama, head of emergency response at the World Health Organziation
(WHO), said: 'We are very concerned, and we are planning for all
scenarios, including the worst-case scenario.'

This comes days after the first confirmed death in the Democratic Republic of Congo (DRC), which also has 11 known sufferers.

Seventeen
recent fatalities are thought to be linked to the Ebola outbreak, while
32 people are suspected to be infected with the virus in the
northwestern area of Bikoro.

The
outbreak, which was confirmed by the DRC's health minister last
Tuesday, is the country's ninth epidemic since the virus was identified
in 1976.

Scientists fear it may be a
'public-health emergency' after an Ebola pandemic killed at least 11,000
when it decimated West Africa between 2014 and 2016.

All
nine countries that neighbour DRC have been put of high alert over the
possible spread of Ebola and international aid teams have flown in to
help.

Three health professionals have died

The
Congo Health Ministry said last Tuesday: 'Our country is facing another
epidemic of the Ebola virus, which constitutes an international public
health emergency.'

Three of the confirmed or suspected sufferers are healthcare workers, of which one has died.

Health
Minister Oly Ilunga said: 'One of the defining features of this
epidemic is the fact that three health professionals have been
affected.

'This situation worries us and requires an immediate and energetic response.'

What is being done to prevent more cases?

The affected region of Bikoro is very remote and difficult for emergency teams to reach.

Mr Salama said: 'Access is extremely difficult... It is basically 15 hours by motorbike from the closest town.'

In addition, to the health team that is already there, the WHO is preparing to send up to 40 specialists in the next week or so.

Mr Salama also stated the UN health organisation hopes to have a mobile lab up and running on site this weekend.

The
WHO and World Food Programme are also working to set up an 'air-bridge'
to help bring in supplies, however, only helicopters can be used until
an airfield is cleared to allow larger planes to land, Mr Salama added.

The
health body has released £738,000 ($1m) from its Contingency Fund for
Emergencies to support response activities for the next three months.

Where could the outbreak spread to?

The
WHO is thought to be particularly concerned about the spread of Ebola
to Mbandaka, the capital of Equateur province, which has around one
million residents and is just a few hours away from Bikoro.

Mr Salama said: 'If we see a town of that size infected with Ebola, then we are going to have a major urban outbreak.'

Nigeria’s immigration service has increased screening tests at airports and other entry points as a precautionary measure.

Similar measures helped the region contain the virus during the West African epidemic that began in 2013.

Officials in Guinea and Gambia both said they have heightened screening measures along their borders.

This comes days after the first
confirmed death in the Democratic Republic of Congo, which also has 11
known sufferers (a health worker is pictured spraying a colleague with
disinfectant during a training session for Congolese health workers to
deal with Ebola four years ago)

How bad have previous outbreaks been?

DRC
escaped the brutal Ebola pandemic, which was finally declared over in
January 2016, but was struck by a smaller outbreak last year.

Four
DRC residents died from the virus in 2017. The outbreak lasted just 42
days and international aid teams were praised for their prompt
responses.

Health experts credit an
awareness of the disease among the DRC population and local medical
staff's experience treating for past successes containing its spread.

The
country's vast, remote geography also gives it an advantage, as
outbreaks are often localised and relatively easy to isolate.

Bikoro,
however, lies not far from the banks of the Congo River, which is
considered to be an essential waterway for transport and commerce.

Further
downstream, the river flows past Kinshasa and Brazzaville, the capital
of Congo Republic. The two cities have a combined population of more
than 12 million people.

Neighbouring countries alerted

Angola,
Zambia, Tanzania, Uganda, South Sudan, Central African Republic,
Rwanda, Burundi and the Republic of Congo - which border the DRC - have
all been alerted.

While Kenya, which does not border the country, has issued warnings over the possible spread of Ebola.

Thermal
guns to detect anyone with a fever have been put in place along its
border with Uganda and at the Jomo Kenyatta International Airport.

Concerned
health officials in Nigeria, which also does not border the DRC, have
put similar measures in place to keep its population safe.

Mass vaccination will not curb epidemics

This comes after research released earlier this month suggested mass vaccinations will not stop http://www.dailymail.co.uk/news/ebola/index.html" rel="nofollow - Ebola outbreaks.

Professor
Martin Michaelis and colleagues examined the prospects of a major Ebola
campaign to dole out jabs to at-risk patients by looking at 35 old
studies.

Writing in the Frontiers in
Immunology, they revealed that controlling an outbreak of the virus
depends entirely on surveillance and the isolation of cases.

At
least 80 per cent of the population would have to receive the vaccine
to establish herd immunity, as the average infected patient passes it
onto four other people.

Yet, Professor
Michaelis pointed to a trial during the Ebola pandemic, which showed
less than half of patients were given a experimental jab.

Currently,
there are no vaccines to protect patients against Ebola and scientists
are unsure if any of the ones under investigation will work in the long
term.

Doling out vaccines to
populations would also be 'costly and impractical', Professor Michaelis
claimed, due to many people at risk living in remote, rural areas.

WHAT IS EBOLA AND HOW DEADLY WAS IT?

Ebola,
a haemorrhagic fever, killed at least 11,000 across the world after it
decimated West Africa and spread rapidly over the space of two years.

The pandemic was officially declared over back in January 2016, when Liberia was announced to be Ebola-free by the WHO.

The
country, rocked by back-to-back civil wars that ended in 2003, was hit
the hardest by the fever, with 40 per cent of the deaths having occurred
there.

Sierra Leone reported the highest number of Ebola cases, with nearly of all those infected having been residents of the nation.

WHERE DID IT BEGIN?

An
analysis, published in the New England Journal of Medicine, found the
outbreak began in Guinea - which neighbours Liberia and Sierra Leone.

A
team of international researchers were able to trace the pandemic back
to a two-year-old boy in Meliandou - about 400 miles (650km) from the
capital, Conakry.

Emile Ouamouno, known
more commonly as Patient Zero, may have contracted the deadly virus by
playing with bats in a hollow tree, a study suggested.

HOW MANY PEOPLE WERE STRUCK DOWN?

WHICH COUNTRIES WERE STRUCK DOWN BY EBOLA DURING THE 2014-16 PANDEMIC? (CDC figures)

COUNTRY

CASES

DEATHS

DEATH RATE (%)

GUINEA

3,814

2,544

66.7%

SIERRA LEONE

14,124

3,956

28.0%

LIBERIA

10,678

4,810

45.0%

NIGERIA

20

8

40.0%

SENEGAL

1

0

N/A

SPAIN

1

0

N/A

US

4

1

25.0%

MALI

8

6

75.0%

UK

1

0

N/A

ITALY

1

0

N/A

Figures show nearly 29,000 people were infected from Ebola - meaning the virus killed around 40 per cent of those it struck.

Cases
and deaths were also reported in Nigeria, Mali and the US - but on a
much smaller scale, with 15 fatalities between the three nations.

Health
officials in Guinea reported a mysterious bug in the south-eastern
regions of the country before the WHO confirmed it was Ebola.

Ebola
was first identified by scientists in 1976, but the most recent
outbreak dwarfed all other ones recorded in history, figures show.

HOW DID HUMANS CONTRACT THE VIRUS?

Scientists
believe Ebola is most often passed to humans by fruit bats, but
antelope, porcupines, gorillas and chimpanzees could also be to blame.

It
can be transmitted between humans through blood, secretions and other
bodily fluids of people - and surfaces - that have been infected.

IS THERE A TREATMENT?

The
WHO warns that there is 'no proven treatment' for Ebola - but dozens of
drugs and jabs are being tested in case of a similarly devastating
outbreak.

Hope exists though, after an
experimental vaccine, called rVSV-ZEBOV, protected nearly 6,000 people.
The results were published in The Lancet journal.

RML releases latest findings on Ebola in same week new outbreak reported in Congo

3 Hours ago

A
study by scientists at Rocky Mountain Laboratories has quieted concerns
the Ebola virus had become even deadlier to humans due to a mutation
during an outbreak that claimed more than 10,000 lives in western
Africa.

Last week's release
of the National Institutes of Health study coincided with news of a new
Ebola virus outbreak in the Democratic Republic of Congo that
reportedly has killed 18.

The
Ebola virus causes a serious illness that is often fatal if not treated.
The virus is transmitted to people from wild animals and then spreads
through the human population when people come in contact with bodily
fluids like saliva, vomit or urine.

First
identified in 1976, the Ebola virus’s impact was limited to a few
thousand people in central Africa before the disease swept through
Liberia, Guinea and Sierra Leone between 2013 to 2016 in an outbreak
that sickened more than 30,000 people and eventually killed more than
10,000.

Early on during that
epidemic, scientists speculated the genetic diversity in the circulating
Mokona strain of the virus would result in more severe disease and
higher rates of transmissibility between humans than prior strains.

RML
staff scientist Andrea Marzi was one of 16 National Institutes of
Health researchers who traveled to Africa during the outbreak to help
facilitate the treatment of people affected by the disease.

Marzi
worked with NIAID’s Laboratory of Virology chief Dr. Heinz Feldmann in
a subsequent study to determine if mutations during the epidemic had
made the disease more deadly to humans.

“At
the end of 2016, there were some publications coming out hypothesizing
that the Ebola virus Makona — which was the causative agent of the
epidemic that devastated West Africa from 2013 to 2016 — might have over
time adapted to humans and therefore spread so widely and caused this
big epidemic,” Marzi said.

Since
RML researchers were involved early on in the response to the outbreak,
they had samples of the virus from the beginning in Guinea. They also
had samples from Liberia and Mali that included the mutations that were
associated with human adaptation of the virus.

The
researchers in Hamilton wanted to test the theory that mutation made
the disease more deadly to humans by using animal models that were often
used in this type of research.

Specially
bred mice that are very susceptible to all types of diseases and rhesus
macaque monkeys were infected with the various virus isolates to both
assess the disease progression and see how the virus would shed.

“We
were unable to find any significant differences between early and late
isolates lacking or carrying those mutations, suggesting that these
mutations did not lead to alterations in the disease-causing ability in
animal models,” the researchers’ study said.

While
the test subjects weren’t human, they were as close as researchers can
come in analyzing these types of research questions, Marzi said.

“Having said that, we were very
surprised to see basically no difference,” she said. “The mutation does
not seem to contribute to more severe disease of pathogenesis.

“Even
though the virus might have adapted to humans by acquiring this
mutation … it did not make the disease worse in humans,” Marzi said.
“Also we do not think it made it spread more. The study did not show the
virus is more easily transmitted via saliva, urine or feces or so (on).
We didn’t see a difference between early isolates and later ones
carrying the mutation.”

The
take away message was that different reasons, other than changes in the
virus, likely caused the outbreak to be so widespread and severe.

“Other
factors, including socio-economic ones, may have contributed,” Marzi
said. “Unlike other outbreaks that occurred in central Africa in small
villages where there wasn’t a lot of traffic, western Africa is highly
populated and people travel a lot between countries. There is a lot of
trade.

“The cities that were
infected were not small villages,” she said. “They were like the
capitals of those countries with a million people living there. Once the
virus gets there, it spreads faster. This may have contributed, too,
not just that the virus mutated and adapted to humans. … Our data
doesn’t support that hypothesis. Mutations in viruses are normal. It may
have moved wider because there were a lot more targets.”

People in West Africa were also slow to react because the disease had not appeared there before.

“In
central Africa, people are very aware that Ebola is around,” Marzi
said. “If someone presents with symptoms, village elders isolate them.
(They) know that it could spread and be devastating. In West Africa in
the beginning, nobody believed Ebola was there. They had to raise
awareness that something bad was going on.”

Marzi spent two months working in Africa during the outbreak in what she calls an opportunity of a lifetime.

“For
me, as a researcher, for the first time I personally could contribute
something on the ground level,” she said. “Even though my skills as a
scientist are so abstract to many people, those skills actually helped
people directly.

“I could
determine which people were really sick from blood that was drawn,”
Marzi said. “Health care workers could limit the contact from the people
who were infected to those people who were not infected and hopefully
ensure they didn’t get the virus.”

There was some fear that went along with going into a place where so many were sick and dying.

“I
washed my hands in bleach so many times that I could smell it for
months afterwards,” she said. “It was quite something, but it was also
one of the best things that I did in my life.”

On 8 May 2018, the Ministry of Health (MoH) of the Democratic
Republic of the Congo declared an outbreak of Ebola virus disease (EVD)
in Bikoro Health Zone, Equateur Province. This is the ninth outbreak of
Ebola virus disease over the last four decades in the country, with the
most recent one occurring in May 2017.

Context

On 3 May 2018, the Provincial Health Division of Equateur reported 21
cases of fever with haemorrhagic signs including 17 community deaths in
the Ikoko-Impenge Health Area in this region. A team from the Ministry
of Health, supported by WHO and Médecins Sans Frontières (MSF) visited
the Ikoko-Impenge Health Area on 5 May 2018 and detected five (5) active
cases, two of whom were admitted to Bikoro General Hospital and three
who were admitted in the health centre in Ikoko-Impenge. Samples were
taken from each of the five active cases and sent for analysis at the
Institute National de Recherche Biomédicale (INRB), Kinshasa on 6 May
2018. Of these, two tested positive for Ebola virus, Zaire ebolavirus
species, by reverse transcription polymerase chain reaction (RT-PCR) on 7
May 2018 and the outbreak was officially declared on 8 May 2018.

The index case has not yet been identified and investigations are underway.

Update

Since the last situation report, an additional Health Zone in
Equateur Province reported EVD cases – Wangata Health Zone in the city
of Mbandaka – with a total of three (3) affected Health Zones as of 14
May 2018.

Waganta Health Zone reported two probable cases on 11 May 2018 with
both cases testing positive by Rapid Diagnostic Testing (RDT) – both
their samples are awaiting PCR confirmation from INRB in Kinshasa. As of
13 May, there is a cumulative total of 41 cases, including 20 deaths
(case fatality rate = 48.8%) and three healthcare workers from Bikoro
(n=2) and Iboko (n=1). Of the 41 cases reported, two cases are
confirmed, 17 are suspected and 22 are probable . A total of 432
contacts are being monitored in the health zones of Bikoro (n=274),
Iboko (n=115) and Mbandaka (n=43) as of 14 May 2018.
With regards to case distribution, Bikoro Health Zone reported the
highest number of cases (n=31), followed by Iboko (n=8) and Mbandaka
(n=2) Health Zones. In the Bikoro Health Zone, 50% of the cases were
reported from the Ikoko-Impenge health area, followed by Bikoro health
area (35.3%), the health facility (14%) and the Moleti health area (7%).
In the Iboko Health Zone, most cases were reported from the Mpangi
health area (80%) with the remaining one case being reported from Itipo
health area. In the Waganta Health Zone in Mbandaka city, the two cases
were both from the Bongozo health area. They are the previously
mentioned probable cases (RDT positive and awaiting PCR confirmation)
and are brothers who had recently stayed in Bikoro for funerals.

I can't help but notice the dates. I did not manage to report this to you until the 8th, when the government first announced the outbreak, but the disease emerged in the human potulation on the 3rd, that is a whole week apart. This is easily explainable by the remoteness of the outbreak. But, what if it was another zoonosis, even more deadly, contagious and slightly slower to kill? That kind of delay would be lethal on a massive scale. I rather doubt that ebola will be the slate wiper, but it is interesting as a case study to prepare for the disease that is.

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: May 16 2018 at 6:32am

May 16, 2018 / 12:03 PM / Updated 37 minutes ago

Congo receives first doses of Ebola vaccine amid outbreak

KINSHASA (Reuters) - The first batch of 4,000 experimental Ebola
vaccines to combat an outbreak suspected to have killed 20 people
arrived in Congo’s capital Kinshasa on Wednesday, said a Reuters witness
at the airport.

The Health Ministry said vaccinations would start on the weekend, the
first time the vaccine would come into use since it was developed two
years ago.

The vaccine, developed by Merck and sent from Europe
by the World Health Organization, is still not licensed but proved
effective during limited trials in West Africa in the biggest ever
outbreak of Ebola, which killed 11,300 people in Guinea, Liberia and
Sierra Leone from 2014-2016.

Health officials hope they can use
it to contain the latest outbreak in northwest Democratic Republic of
Congo which the WHO believes has so far killed 20 people since April.

Health
workers have recorded two confirmed cases, 22 probable cases and 17
suspected cases of Ebola in three health zones of Congo’s Equateur
province, and identified 432 people who may have had contact with the
disease.

WHO spokesman Tarik Jasarevic said the vaccine will be
reserved for people suspected of coming into contact with the disease,
and that a second batch of 4,000 doses would be sent in the coming days.

“In
our experience, for each confirmed case of Ebola there are about
100-150 contacts and contacts of contacts eligible for vaccination,”
Jasarevic said. “So it means this first shipment would be probably
enough for around 25-26 rings - each around one confirmed case.”

The WHO said it had sent 300 body bags for safe burials in affected communities.

The
outbreak was first spotted in the Bikoro zone, which has 31 of the
cases and 274 contacts. There have also been eight cases and 115
contacts in Iboko health zone.

The WHO is worried about the
disease reaching the city of Mbandaka with a population of about 1
million people, which would make the outbreak far harder to tackle. Two
brothers in Mbandaka who recently stayed in Bikoro for funerals are
probable cases, with samples awaiting laboratory confirmation.

The
WHO report said 1,500 sets of personal protective equipment and an
emergency sanitary kit sufficient for 10,000 people for three months
were being put in place.

To add to my previous point, It has taken two weeks to decide to use the vaccine and get it to the appropriate area. Impressive, but probably not fast enough in the case of disease X.

-------------Absence of proof is not proof of absence.

Posted By: tiger_deF
Date Posted: May 16 2018 at 11:54am

While this outbreak is happening in a pretty rural area of Africa the lack of media coverage is almost as suprising as the total lack of updates. The only source of info we have is who updates every couple of days

Posted By: Technophobe
Date Posted: May 16 2018 at 1:01pm

I expect they just want to show off their new vaccine..............

-------------Absence of proof is not proof of absence.

Posted By: carbon20
Date Posted: May 16 2018 at 2:43pm

in parts of Africa ,it is a custom ,when young woman are going to get married,the sleep with a man ,i think known as a leopard,he has sex with them to teach them how to please their new husband,(this might be at puberty not sure of the age yet will research it ),

a few years ago there was a case that the "Leopard"didnt use a condom and infected many young woman with HIV,

23 deaths42 known casesThe disease has spread to Mbandaka (a city of over a million people)

It transpires that the vaccine the WHO has been relying on to contain the virus by ring-vaccination has to be stored at between -60C to -80C which is almost impossible in the remote areas where emerging zoonosises like ebola appear.

As usual with ebola, there is some arguement about how bad things are so here are several links each with their own take on affairs. The Telegraph, Reuters and the BBC all have great reputations for accuracy.

https://www.vanguardngr.com/2018/05/fresh-ebola-outbreak-ncaa-issues-guidelines-airlines-urges-vigilance/" rel="nofollow - https://www.vanguardngr.com/2018/05/fresh-ebola-outbreak-ncaa-issues-guidelines-airlines-urges-vigilance/ gives the instructions to the local airlines and http://www.npr.org/sections/goatsandsoda/2018/05/15/611267872/can-the-new-ebola-vaccine-stop-the-latest-outbreak" rel="nofollow - http://www.npr.org/sections/goatsandsoda/2018/05/15/611267872/can-the-new-ebola-vaccine-stop-the-latest-outbreak gives details of the vaccine used and its effectiveness in the last outbreak.

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: May 17 2018 at 2:45am

Ethiopia Declares Maximum Alert for New Outbreak of Ebola in DRC

Addis Ababa, May 13 (Prensa Latina) The
Ethiopian government declared a maximum alert to counteract the Ebola
virus disease after an outbreak in the Democratic Republic of Congo
(DRC) this week.

According to the Ethiopian Health Ministry, inspections are carried out
at the main international airports and in the border areas to prevent
the entry of the deadly disease.

The organization specified that
clinics and hospitals throughout the country received the necessary
equipment to treat suspected cases of Ebola, and training is being given
to strengthen response capabilities.

A new outbreak was
declared on Tuesday by the government of the DRC, after two samples
tested positive in Bikoro, province of Equateur.

The African
Union (AU) announced that the Center for Disease Control and Prevention
(CDC of Africa) activated an emergency operation to support the fight
against the epidemic.

Thus, the CDC mobilized combat resources
for an imminent deployment; The team includes experts with experience in
the treatment of the condition, who in turn participated in the 2014
pandemic that affected West Africa.

At that time, Ethiopia also previously sent a medical team, made up of about 200 health workers.

[Technophobe: The CDC may be relying on the vaccine, but at least someone is taking care in case it does not work.]

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: May 17 2018 at 2:52am

[Technophobe: Reports seem to be quite varied on the scope of the spread to Mbandaka. I have come across reports that three people there had the disease, which I find unlikely this early. This is the most up-to-the-minute report I can find and that says one person in the city has the diseae.]

The Democratic Republic of Congo’s efforts to head off an Ebola
epidemic is running into obstacles, with the announcement of the first
registered urban case.

Health officials have https://af.reuters.com/article/drcNews/idAFL5N1SN409" rel="nofollow - confirmed a case
in the northwest city of Mbandaka, a busy river port located at the
intersection of the Congo and Ruki rivers and with trade routes to the
capital Kinshasa. The spread of the deadly virus from the countryside
and into a city that is home to about a million people pushes the
current outbreak into a “new phase,” essentially making the efforts to
contain the outbreak far harder.

Authorities said they were tracing all air, river, and road routes in
and out of the city to find the source of the virus. Two brothers in
Mbandaka who recently visited the outbreak’s starting point in Bikoro
town are probable cases, with samples awaiting laboratory confirmation.
So far, 23 people are known to have died while 42 others have been
infected since the https://qz.com/1273712/drc-congo-ebola-outbreak-kills-17/" rel="nofollow - outbreak started earlier this month.

The announcement came just as thousands of doses of the experimental
Ebola vaccine arrived in the country, with vaccinations expected to
commence this coming weekend. Sent by the World Health Organization, the
vaccine is still not licensed but proved effective in the 2014 Ebola
outbreak in West Africa. WHO says it will use the https://www.cbsnews.com/news/congo-ebola-outbreak-experimental-vaccine-arrives/" rel="nofollow - “ring vaccination” method
by administering the treatment to voluntary contacts, and contacts of
those contacts, besides health workers. The health body also sent 300
body bags for safe burials in affected communities.

The swift response to quickly tackle the outbreak is in contrast to
the response to the 2014 outbreak, when international agencies and
governments were criticized for their slow response. More than 11,300
people http://www.bbc.com/news/world-africa-28755033" rel="nofollow - were confirmed dead between March 2014 and Jan. 2016 in Liberia, Guinea, Sierra Leone, Nigeria, the US, and Mali.

In the DR Congo, a quick response is also crucial given https://qz.com/1276165/ebola-in-drc-congo-kills-17-in-a-race-against-time-nigeria-to-help/" rel="nofollow - the recurring nature of the virus in the nation: since 1976, there have been https://www.nation.co.ke/news/africa/Ebola-kills-17-in--DR-Congo/1066-4551576-bx7k8y/index.html" rel="nofollow - nine major outbreaks of the deadly virus in the central African nation.

WHO calls emergency meeting on Congo's Ebola outbreak

The U.N. World Health Organization will
convene an Emergency Committee on Friday to consider the international
risks of an Ebola outbreak in the Democratic Republic of Congo, WHO
spokesman Christian Lindmeier said on Thursday.

GENEVA: The U.N. World Health Organization
will convene an Emergency Committee on Friday to consider the
international risks of an Ebola outbreak in the Democratic Republic of
Congo, WHO spokesman Christian Lindmeier said on Thursday.

The
expert committee will decide whether to declare a "public health
emergency of international concern", which would trigger more
international involvement, mobilising research and resources, Lindmeier
said

[Technophobe: There is not much information
available this morning, but this up-to-the-minute report is both
detailed and from a well respected source. It also gives rather clearer
figures than most of the others who do not divide up the figures so
precicely.]

DR Congo Ebola outbreak: WHO in emergency talks as cases spread

7 hours ago

The World Health Organization (WHO)
is to hold an emergency meeting to discuss the risk of Ebola spreading
from the Democratic Republic of Congo.

http://www.who.int/csr/don/17-may-2018-ebola-drc/en/" rel="nofollow - A panel will decide on Friday whether to declare a "public health emergency of international concern" , which would trigger a larger response.

At least 44 people are believed to have been infected in the current outbreak and 23 deaths are being investigated.

Cases emerged in a rural area with one now confirmed in the city of Mbandaka.

The
city of about one million people is a transport hub on the Congo River,
prompting fears that the virus could now spread further, threatening
the capital Kinshasa and surrounding countries.

Ebola is an infectious illness that causes internal bleeding and often
proves fatal. It can spread rapidly through contact with small amounts
of bodily fluid, and its early flu-like symptoms are not always obvious.

http://www.bbc.co.uk/news/health-30974649" rel="nofollow - WHO has previously admitted that it was too slow to respond to a deadly Ebola outbreak in West Africa from 2014-2016 that killed more than 11,000 people.

Why is the case in Mbandaka a concern?

Senior
WHO official Peter Salama said the spread to Mbandaka meant there was
the potential for an "explosive increase" in cases.

"This is a
major development in the outbreak," he told the BBC. "We have urban
Ebola, which is a very different animal from rural Ebola. The potential
for an explosive increase in cases is now there."

Mr Salama, the WHO's deputy director-general for emergency response,
said Mbandaka's location on the Congo river raised the prospect of Ebola
spreading to Congo-Brazzaville and the Central African Republic, as
well as downstream to Kinshasa, which has a population of 10 million.

"This
puts a whole different lens on this outbreak and gives us increased
urgency to move very quickly into Mbandaka to stop this new first sign
of transmission," he said.

The 2014-16 West Africa outbreak became particularly deadly when it spread to the capitals of Guinea, Sierra Leone and Liberia.

What is being done to contain the outbreak?

WHO says that of the 44 Ebola cases reported, three are confirmed, 20 are probable, and 21 are suspected.

They were recorded in Congo's Equateur province. Mbandaka is the provincial capital.

Mr Salama said that isolation and rudimentary management facilities had been set up in Mbandaka.

He
said the disease could have been taken there by people who attended the
funeral of an Ebola victim in Bikoro, the south of Mbandaka, before
travelling to the city.

On Wednesday more than 4,000 doses of an experimental vaccine sent by
the WHO arrived in Kinshasa with another batch expected soon.

These
would be given as a priority to people in Mbandaka who had been in
contact with those suspected of carrying the Ebola virus before people
in any other affected area, Mr Salama said.

The vaccine, from
pharmaceutical firm Merck, is unlicensed but was effective in limited
trials during the West Africa outbreak. It needs to be stored at a
temperature of between -60 and -80 C. Electricity supplies in Congo are
unreliable.

WHO said health workers had identified 430 people who
may have had contact with the disease and were working to trace more
than 4,000 contacts of Ebola patients who had spread across north-west
DR Congo.

Many of these people were in remote areas, Mr Salama said.

Why does Ebola keep returning?

There
have been three outbreaks in DR Congo since the 2014-16 epidemic. Ebola
is thought to be spread over long distances by fruit bats and is often
transmitted to humans via contaminated bushmeat.

It can also be
introduced into the human population through contact with the blood,
organs or other bodily fluids of infected animals. These can include
chimpanzees, gorillas, monkeys, antelope and porcupines.

It is not
possible to eradicate all the animals who might be a host for Ebola. As
long as humans come in contact with them, there is always a possibility
that Ebola could return.

[Technophobe: Now the WHO says the risk has risen to 'very high'. Well, no sh:it, Sherlock‽ Here are their conclusions:]

WHO says Congo faces 'very high' risk from Ebola outbreak

https://www.reuters.com/journalists/tom-miles" rel="nofollow - Tom Miles GENEVA (Reuters) - Democratic Republic of Congo faces a “very high”
public health risk from Ebola because the disease has been confirmed in a
patient in a big city, the World Health Organization (WHO) said on
Friday, raising its assessment from “high” previously.

The risk to countries in the region was now “high”, raised from “moderate”, but the global risk remained “low”, the WHO said.

The
reassessment came after the first confirmed case in Mbandaka, a city of
around 1.5 million in the northwest. Previous reports of the disease
had all been in remote areas where Ebola might spread be more easily
contained.

“The
confirmed case in Mbandaka, a large urban center located on major
national and international river, road and domestic air routes,
increases the risk of spread within the Democratic Republic of the Congo
and to neighboring countries,” the WHO said.

WHO Deputy Director-General for Emergency Preparedness and Response
Peter Salama had told reporters on Thursday that the risk assessment was
being reviewed.

“We’re certainly not trying to cause any panic in the national or international community,” he said.

“What
we’re saying though is that urban Ebola is very different phenomenon to
rural Ebola because we know that people in urban areas can have far
more contacts so that means that urban Ebola can result in an
exponential increase in cases in a way that rural Ebola struggles to do."

Later on Friday, the WHO will convene an Emergency Committee of
experts to advise on the international response to the outbreak, and
decide whether it constitutes a “public health emergency of
international concern”.

The nightmare scenario is an outbreak in
Kinshasa, a crowded city where millions live in unsanitary slums not
connected to a sewer system.

Jeremy Farrar, an infectious disease
expert and director of the Wellcome Trust global health charity, said
the outbreak had “all the features of something that could turn really
nasty”.

“As more evidence comes in of the separation
of cases in space and time, and healthcare workers getting infected, and
people attending funerals and then traveling quite big distances - it’s
got everything we would worry about,” he told Reuters.

The WHO
statement said there had been 21 suspected, 20 probable and 3 confirmed
cases of Ebola between April 4 and May 15, a total of 44 cases,
including 15 deaths. Mbandaka had three suspected cases in addition to
the confirmed case.

The WHO is sending 7,540 doses of an
experimental vaccine to try to stop the outbreak in its tracks, and
4,300 doses have already arrived in Kinshasa. It will be used to protect
healthworkers and “rings” of contacts around each case.

The
vaccine supplies will be enough to vaccinate 50 rings of 150 people, the
WHO said. As of 15 May, 527 contacts had been identified and were
being followed up and monitored.

Hey just learned that there is a vaccine for Ebola and it works. Is Ebola something we can put down now that there is a vaccine?

-------------Always Be Prepared

Posted By: Technophobe
Date Posted: May 18 2018 at 7:40am

I don't think it was ever much of a risk, as it kills too fast, so its spread is self-limiting. The vaccine reduces the risk even further, FluMom, but does not erase it completely.

The vaccine appears to work very well, but requires some very specific and difficult storage conditions. That causes big distribution problems. Also, we do not yet know how easy it is to make (production line of millions of doses, or handmade hundreds?). On top of that, how good is ebola at mutating; will the vaccine continue to work or does it need changing like the flu?

Personally, I expect this is the end of all things ebola, but we will have to wait to find out if I am right.

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: May 18 2018 at 11:05am

Ebola: two more cases confirmed in Mbandaka in DRC

Total of three cases confirmed in city of 1 million people, raising fears of wider outbreak

Two more cases of Ebola have been confirmed in the north-western city of Mbandaka in the https://www.theguardian.com/world/congo" rel="nofollow - Democratic Republic of the Congo , health officials have said.

The report brings to three the number of confirmed cases in the city of 1 million people, raising the https://www.theguardian.com/global-development/2018/may/18/congo-enters-uncharted-territory-as-it-faces-gravest-ebola-challenge-to-date" rel="nofollow - prospect of a wider outbreak than feared.

The DRC is one of Africa’s most fragile states, with millions
threatened by hunger, disease and low-level conflict. Political
instability has intensified since the refusal of Joseph Kabila to https://www.theguardian.com/world/2018/jan/23/congo-steps-up-deadly-crackdown-after-more-protests-against-kabila" rel="nofollow - step down as president when his second term ended in 2016.

International aid is pouring in to reinforce health services, with a
campaign of vaccinations due to begin on Sunday. The health ministry
declared it had activated an action plan in Mbandaka.

After visiting the city, which is 360 miles (580km) from the capital,
Kinshasa, the health minister, Oly Ilunga, announced on television that
all healthcare would be free. “Financial hurdles should not in any way
be a brake to having access to healthcare, especially at a time of
epidemic,” he said.

http://www.who.int/csr/disease/ebola/advisory-groups/bio-muyembe/en/" rel="nofollow - Prof Jean-Jacques Muyembe ,
the director general of the DRC’s National Institute for Biomedical
Research, told the Guardian on Friday that “the situation had evolved
overnight with the confirmation of two new cases” in the Wangata
neighbourhood of Mbandaka.

“It is very concerning. It’s a big city. We are all doing everything we can, but nonetheless with https://www.theguardian.com/world/ebola" rel="nofollow - Ebola there are always surprises,” said Muyembe.

The discovery of the first case in Mbandaka this week was described as a “major gamechanger” by the https://www.theguardian.com/world/world-health-organization" rel="nofollow - World Health Organization .
An emergency meeting of experts was held on Friday to consider the
danger of the disease spreading to other countries. “At the global
level, the risk is currently low,” the WHO said.

Late on Thursday, the DRC health ministry confirmed 11 previously suspected cases of https://www.theguardian.com/world/ebola" rel="nofollow - Ebola and two more deaths, taking the total number of cases, including 25 deaths, to 45.

All the deaths so far have occurred in Bikoro, a rural area about 75
miles from Mbandaka. The presence of the disease in more isolated areas
has given authorities a better chance of preventing its spread.

Muyembe said laboratory results released late on Thursday had
confirmed the two new cases. He was unable to give any further details
about whether the individuals knew each other. The aid agency Médecins
san Frontières, however, said it was aware of only one new
laboratory-based confirmation from Mbandaka.

Mbandaka is located on the banks of the Congo river, a key trade and
transport route into Kinshasa, though experts said water transport
between the cities could take weeks, slowing any potential spread of the
disease. Air transport is limited and expensive.

Ebola has twice made it to DRC’s capital in the past and was rapidly stopped.

Ilunga said epidemiologists were working to identify people who had
been in contact with suspected cases, and authorities would intensify
population tracing on routes out of Mbandaka.

This is a big task even for medical services in developed countries, but the DRC is one of the world’s poorest.

Four times the size of France, the DRC has been chronically unstable and https://www.theguardian.com/global-development/2018/feb/02/democratic-republic-of-the-congo-gripped-by-fear-as-thousands-flee-bone-chilling-violence" rel="nofollow - episodically racked by violence since it gained independence from Belgium in 1960. Hospitals, roads and electricity have problems, especially in remote areas.

In Mbandaka, medical staff have been issued with infrared pistol
thermometers to check travellers for high temperatures, as well as soap
and basins of water, and logbooks for writing down visitors’ names and
addresses.

In the privately run port of Menge, health ministry workers were
systematically checking people’s temperatures with thermometers. But
Joseph Dangbele, a port official, said: “We don’t have enough of the
thermometers, so people are crowding up and getting annoyed.”

On Thursday, a doctor at Mbandaka general hospital, who requested
anonymity, said more than 300 people in the city had either direct or
indirect contact with Ebola.

-------------Accept responsibility for your choices and actions. Failure to choose is in itself a choice for non-action.

Posted By: Technophobe
Date Posted: May 18 2018 at 2:30pm

The Guardian says two more confirmed in the city raising the number to three there, pcusick.

Admitedly, no one else has claimed this yet, but the Guardian is not some rag. It is a serious (albeit rather left-wing) newspaper with a great reputation for accuracy. I know, the WHO is the bottom line, but they do not have a reputation for being forthcoming with information. They prefer to avoid panic, sometimes even at the expense of the truth.

Most of us AFTers learned not to trust them during the last ebola outbreak. Thankfully, Margaret Chan is now gone, so perhaps they will have improved. Who knows?

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: May 19 2018 at 12:38am

Statement on the 1st meeting of the IHR Emergency Committee regarding the Ebola outbreak in 2018

18 May 2018

Statement

The 1st meeting of the Emergency Committee convened by
the WHO Director-General under the International Health Regulations
(IHR) (2005) regarding the Ebola Virus Disease (EVD) outbreak in the
Democratic Republic of the Congo took place on Friday 18 May 2018, from
11:00 to 14:00 Geneva time (CET).

Emergency Committee conclusion

It was the view of the Committee that the conditions for a Public
Health Emergency of International Concern (PHEIC) have not currently
been met.

Meeting

http://www.who.int/docs/default-source/documents/list-2018-international-health-regulations-emergency-committee-for-ebola-viral-disease.pdf" rel="nofollow - Members and advisors of the Emergency Committee
met by teleconference. Presentations were made by representatives of
the Democratic Republic of the Congo on recent developments, including
measures taken to implement rapid control strategies, and existing gaps
and challenges in the outbreak response. During the informational
session, the WHO Secretariat provided an update on and assessment of the
Ebola outbreak.

The Committee’s role was to provide to the Director-General their views and perspectives on:

Whether the event constitutes a Public Health Emergency of International Concern (PHEIC)

If the event constitutes a PHEIC, what Temporary Recommendations should be made

Current situation

On 8 May, WHO was notified by the Ministry of Health of the
Democratic Republic of the Congo of two lab-confirmed cases of Ebola
Virus Disease occurring in Bikoro health zone, Equateur province. Cases
have now also been found in nearby Iboko and Mbandaka. From 4 April to
17 May 2018, 45 EVD cases have been reported, including in three health
care workers, and 25 deaths have been reported. Of these 45 cases, 14
have been confirmed. Most of these cases have been in the remote Bikoro
health zone, although one confirmed case is in Mbandaka, a city of 1.2
million, which has implications for its spread.

Nine neighbouring countries, including Congo-Brazzaville and Central
African Republic, have been advised that they are at high risk of spread
and have been supported with equipment and personnel.

Key Challenges

After discussion and deliberation on the information provided, the Committee concluded these key challenges:

The Ebola outbreak in the Democratic Republic of the Congo has
several characteristics that are of particular concern: the risk of more
rapid spread given that Ebola has now spread to an urban area; that
there are several outbreaks in remote and hard to reach areas; that
health care staff have been infected, which may be a risk for further
amplification.

The risk of international spread is particularly high since the
city of Mbandaka is in proximity to the Congo river, which has
significant regional traffic across porous borders.

There are huge logistical challenges given the poor
infrastructure and remote location of most cases currently reported;
these factors affect surveillance, case detection and confirmation,
contact tracing, and access to vaccines and therapeutics.

However, the Committee also noted the following:

The response by the government of the Democratic Republic of the Congo, WHO and partners has been rapid and comprehensive.

Interventions underway provide strong reason to believe that the
outbreak can be brought under control, including: enhanced
surveillance, establishment of case management facilities, deployment of
mobile laboratories, expanded engagement of community leaders,
establishment of an airbridge, and other planned interventions.

In addition, the advanced preparations for use of the investigational vaccine provide further cause for optimism for control

In conclusion, the Emergency Committee, while noting that the
conditions for a PHEIC are not currently met, issued Public Health
Advice as follows:

Government of the Democratic Republic of the Congo, WHO, and
partners remain engaged in a vigorous response – without this, the
situation is likely to deteriorate significantly. This response should
be supported by the entire international community.

Global solidarity among the scientific community is critical and international data should be shared freely and regularly.

It is particularly important there should be no international travel or trade restrictions.

During the response, safety and security of staff should be
ensured, and protection of responders and national and international
staff should prioritised.

Exit screening, including at airports and ports on the Congo
river, is considered to be of great importance; however entry screening,
particularly in distant airports, is not considered to be of any public
health or cost-benefit value.

Robust risk communication (with real-time data), social
mobilisation, and community engagement are needed for a well-coordinated
response and so that those affected understand what protection measures
are being recommended;

If the outbreak expands significantly, or if there is international spread, the Emergency Committee will be reconvened.

The Committee emphasized the importance of continued support by WHO
and other national and international partners towards the effective
implementation and monitoring of this advice.

Based on this advice, the reports made by the affected States
Parties, and the currently available information, the Director-General
accepted the Committee’s assessment and on 18 May 2018 did not declare
the Ebola outbreak in the Democratic Republic of the Congo a Public
Health Emergency of International Concern (PHEIC). In light of the
advice of the Emergency Committee, WHO advises against the application
of any travel or trade restrictions. The Director-General thanked the
Committee Members and Advisors for their advice.

Experimental drugs poised for use in Ebola outbreak

International health organizations are in
discussions with the Democratic Republic of Congo about how and whether
to deploy treatments in addition to a vaccine.

Aid workers responding to the Ebola virus outbreak in the Democratic
Republic of Congo (DRC) are seeking approval to treat patients with
experimental drugs. These include three potential treatments — ZMapp,
favipiravir and GS-5734 — that were given to patients during the 2014–16
Ebola outbreak in West Africa.

The three drugs are being considered in addition to an existing plan https://www.nature.com/news/successful-ebola-vaccine-provides-100-protection-in-trial-1.18107" rel="nofollow - to deploy an experimental vaccine ; none of the treatments has been definitively proved to lower the risk of death from Ebola.

The
move to test experimental drugs and vaccines early in the outbreak,
which was confirmed on 8 May, is part of a push to start research as
soon as possible after Ebola cases are detected in order to save lives.
That’s a change from the past, when doing research during an outbreak
was seen as a distraction.

“In the past our major objective was
containment," said Peter Salama, the World Health Organization (WHO)
director-general for emergencies, at an 18 May press conference. "One of
the paradigm shifts we’re seeing in this response is to offer
communities a lot more."

The switch has been driven by the
availability of new vaccines and drugs — and by memories of the 2014–16
epidemic. Officials were so https://www.nature.com/news/how-to-beat-the-next-ebola-1.18114" rel="nofollow - slow to deploy potential vaccines and drugs
that the epidemic had waned before clinical trials could start. “What’s
changed is that there’s an acceptance that research during an outbreak
is something we need to do. It’s an opportunity and an obligation, not a
luxury item,” says Daniel Bausch, director of the UK Public Health
Rapid Support Team in London.

Although it took weeks or months to
greenlight the use of experimental treatments in previous Ebola
outbreaks, public-health officials say that it could happen more quickly
now. The DRC https://www.nature.com/news/ebola-vaccine-approved-for-use-in-ongoing-outbreak-1.22024" rel="nofollow - allowed the use of an experimental Ebola vaccine during its last outbreak ,
in May 2017, although the outbreak ended before the vaccine was
shipped. Earlier this month the government approved the shipment of
4,000 doses of the vaccine. They arrived in the DRC on 16 May and could
be administered next week to outbreak responders, patients and their
contacts, says Jean-Jacques Muyembe-Tamfum, director-general of the
National Institute for Biomedical Research in Kinshasa. “The Congolese
went through this a year ago and they recognize vaccines and
therapeutics as a potential solution to the problem,” says Bausch.

Emergency measures

Public-health
experts hope that the experimental vaccine, called rVSV-ZEBOV, will
help to control the outbreak. Forty-five people have been infected and
25 have died, the WHO said on 18 May. The virus has spread over a wide
geographical area and infected at least one person in a major city,
Mbandaka, which has a population of 1.2 million.

The rVSV-ZEBOV
vaccine, manufactured by Merck, was shown to be highly protective
against Ebola in a trial run during the West African outbreak. None of
the 5,837 volunteers who took the vaccine in that trial became infected
with the virus.

Officials in the DRC have quashed eight previous
outbreaks through conventional public-health measures, such as tracking
down people with Ebola and their contacts to understand the disease’s
path. But they are concerned about how far the virus has already
travelled in the current outbreak — including its entry into a major
city — and by the possibility that it could spread even farther, as did
the West African epidemic, which took root in three countries and
claimed more than 11,000 lives.

“We think the outbreak could
become complicated, as it did in West Africa, so we must do everything
to stop it as soon as possible,” says Muyembe-Tamfum.

Practical and ethical questions

Whether
that will include deploying experimental drugs in addition to the
vaccine is now under discussion. The WHO is consulting experts to
consider the evidence for such treatments, and the medical humanitarian
organization Médecins Sans Frontières (MSF) is talking to DRC officials
about the possibility of using experimental Ebola medicines, says Annick
Antierens, who coordinates Ebola clinical trials for MSF.

Although
the rVSV-ZEBOV vaccine could help to prevent people from becoming
infected, Antierens says, experimental treatments might still be needed
because officials lack a thorough understanding of where Ebola first
emerged during this outbreak or how it is spreading. So there are likely
to be very many people who have already been infected.

“It we’re
lucky and the disease doesn’t spread, the outbreak will be quickly
resolved and we will have to use few experimental products,” Antierens
says. “But if we’re unlucky we’ll need to use them.”

Administering
experimental vaccines and drugs in an outbreak raises ethical and
logistical complexities, such as delivering them to remote settings by
aeroplane or motorbike and https://www.nature.com/news/ethical-dilemma-for-ebola-drug-trials-1.16317" rel="nofollow - designing humane and rigorous clinical trials .
The 2014–16 Ebola outbreak saw intense controversy over whether
potential drugs and vaccines should be tested in randomized controlled
trials, in which patients are assigned by chance to receive either the
experimental treatment or standard care. MSF and officials at the WHO
argued that withholding experimental medicines from patients who had few
other options would be unethical.

The treatments MSF is now
considering include the antibody treatment ZMapp, and two antiviral
drugs, favipiravir and GS-5734, which were given to varying numbers of
patients in the 2014–16 epidemic.

Zmapp, made by Mapp
Biopharmaceutical in San Diego, California, was tested in a trial
involving 72 patients; 22% of the 36 people who received the drug died,
compared with 37% of the 35 who did not receive ZMapp. But the Ebola
outbreak ended before the study was able to enrol the 200 people needed
to obtain a statistically significant result.

ZMapp is also
impractical for use in remote settings, such as parts of Bikoro and
Iboko, the two health zones in Équateur province that have seen the most
Ebola cases in this outbreak so far. There is an extremely limited
supply of the drug, several doses must be administered by intravenous
infusion under constant supervision, each infusion takes many hours, and
the drug must be refrigerated.

Sparse data﻿

Favipiravir,
an antiviral drug made by the Japanese company Toyama Chemical, was
given to 126 patients in the West African outbreak, and a few dozen
patients in other trials. GS-5734 was given to three people, including
an infant and a Scottish nurse who developed meningitis months after
apparently recovering from an acute Ebola infection. Both the nurse and
the infant survived; the infant was the first documented case of a baby
surviving Ebola.

Favipiravir and GS-5734 would be easier than
ZMapp to administer to patients during the outbreak, as neither needs to
be refrigerated. But the drugs have not been proved to improve the
chance that people will survive an Ebola infection, because the
favipiravir trial was not designed to test efficacy, and GS-5734 has
been tested in so few patients.

The Congolese Ministry of Health
and a national ethics review board would need to greenlight trials of
these treatments. Observers say that the trials, if approved, must
proceed more equitably than they did in the 2014–16 outbreak, when
experimental treatments were given first to international doctors and
aid workers.

“We were pretty tone deaf. The interventions were
used first and primarily on Westerners, including medevacing them out of
the country and treating them,” says Lawrence Gostin, director of the
WHO Collaborating Center on Public Health Law and Human Rights at
Georgetown University in Washington DC. “We need to do that completely
differently this time.”

The World Health Organisation has urged the international community to provide $26m to contain a growing outbreak of the Ebola virus in the Democratic Republic of Congo or risk a much larger bill if the epidemic spreads.

Medical authorities have identified 45 Ebola cases since the DRC government informed the WHO of the outbreak on May 8, of which 25 have been fatal. The vast majority of these are in the remote Bikoro area, 400km north-east of the capital Kinshasa.

But on Thursday the first case was identified in a city, Mbandaka, 150km from the other cases. Late on Friday, two more were found. This prompted the WHO to raise the risk awareness to “very high” for the country and “high” for the region.

Peter Selama, WHO deputy director-general, said the amount requested, which is expected to cover the next three months, was “relatively small”.

“If we can stamp out this outbreak now [it will be] a major gain in terms of lives saved, most importantly, but also in terms of dollars saved,” he told a press conference in Geneva. “That may sound like a considerable sum of money, but let us remember that the Ebola west Africa outbreak two years [ago] cost the international community between three and four billion dollars.”

Dr Selama said the WHO had already received pledges for almost $9m of the funds requested.

Robert Steffen, chairman of a WHO emergency committee that met on Friday to assess the threat, said the “poor infrastructure and remote location” presented huge challenges in containing the outbreak. “These factors affect surveillance, case detection and confirmation, and also contact tracing and access to therapeutics.”

He also warned that the “risk of international spread is particularly great”. Mbandaka is a major transport hub on the Congo River with routes into the DRC capital. “You can travel on it to Kinshasa and Brazzaville [the capital of the Republic of Congo],” he said. There is significant regional traffic across porous borders.”

However the committee said it was premature to declare a public health emergency of international concern. “The immediate response of the government of the Democratic Republic of Congo, the WHO and other partners…. provides strong reason to believe this situation can be brought under control,” Mr Steffen said.

More than 8,000 trial vaccine doses, developed by Merck, have arrived in DRC and the WHO said these would be distributed in the next few days.

Jeremy Farrar, director of Wellcome, a biomedical research charity, said that this outbreak of Ebola was “really serious” compared to the last one in DRC, which killed four people last year, because it has been going on for several months and so is geographically dispersed over an area that is close to cities. The strain of the virus is also similar to the one in west Africa in 2014-16.

“The next two or three weeks will be crucial,” he said. “If the numbers stabilise and we don’t have multiple transmission then it should be containable. But if the numbers are going up, there are multiple transmissions in cities, cross-border infections and health workers getting infected then all bets are off.”

Congo announces six new confirmed cases of Ebola virus

SALEH MWANAMILONGO AND CARLEY PETESCH

Last updated 03:36, May 23 2018

Congo's health ministry announced six new confirmed Ebola cases and
two new suspected cases on Tuesday as vaccinations entered a second day
in an effort to contain the deadly virus in a city of more than 1
million.

Dozens of health workers in the northwestern provincial
capital, Mbandaka, have received vaccinations amid expectations that
some will be deployed to the rural epicenter of the epidemic.

Front-line
workers are especially at risk of contracting the virus, which spreads
in contact with the bodily fluids of infected people, including the
dead.

"In the next five days 100 people must be vaccinated,
including 70 health professionals," Health Minister Oly Ilunga said.
"The priority of the government is to ensure that all these brave health
professionals can do their job safely."

Congo's
health ministry said there are now 28 confirmed Ebola cases, 21
probable ones and two suspected. The six new confirmed cases were in the
rural Iboko health zone, it said. Of the confirmed Ebola cases, 14 are
in Iboko, 10 are in Bikoro where the outbreak began and four are in the
Wangata area of Mbandaka.

The death toll from hemorrhagic fever
stands at 27, with three of them confirmed as Ebola. Two of the Ebola
victims were nurses, one in Iboko and the other in Bikoro.

"Our hope is that ... the sick will heal, the whole province will be healed," Elange said.

JOHN MOORE/GETTY IMAGES

Two dozen vaccinators, including Congolese and Guineans who
administered the vaccine in their country during the 2014-2016 outbreak,
are in Mbandaka to start injecting the 540 doses that have arrived.
(File photo)

The World Health Organization said 33 people received the first
vaccinations on Monday, including a few people in two communities of
Mbandaka. More than 7500 doses are available in Congo, WHO said on
Monday, and another 8000 doses will be available in the coming days.

The vaccination campaign eventually will move to cover the two other health zones where confirmed cases have been reported.

The
vaccine, provided by US company Merck, is still in the test stages but
it was effective toward the end of the Ebola epidemic that killed more
than 11,300 people in Guinea, Sierra Leone and Liberia from 2014 to
2016.

A major challenge will be keeping the vaccines cold in this vast, impoverished, tropical country where infrastructure is poor.

Those
who are vaccinated in outbreak areas still will have to strictly follow
infection-control measures, especially since the vaccine doesn't
protect immediately. It takes a week to 10 days, said Dr Pierre Rollin,
an epidemiologist with the US Centers for Disease Control and Prevention
and a veteran of more than a dozen Ebola outbreaks.

Rollin warned
that the large geographic area between Mbandaka and the remote towns
where the outbreak's first cases were reported must be scoured for the
infected and the people who have come into contact with them.

"Travel
from Mbandaka to Bikoro can take four hours to four days" depending on
transportation and if it's raining, he said. "Before making any
assumption we're going to have to look along this road and all the
villages."

KARSTEN VOIGT/AP

Members of a Red Cross team don protective clothing before
heading out to look for suspected victims of Ebola, in Mbandaka, Congo.

The US Agency for International Development on Tuesday said it was
contributing another up to US$7 million (NZ$10.1 million) to combat the
outbreak on top of the US$1 million (NZ$1.4 million) it committed last
week.

The International Federation of Red Cross and Red Crescent
Societies in Congo warned that the outbreak is far from over. It said it
will expand operations for community-based surveillance and safe
burials.

"The risk of spreading within the country and to
neighbouring nations remains real," said Dr Fatoumata Nafo-Traore,
IFRC's regional director for Africa.

This is Congo's ninth Ebola
outbreak since 1976, when the disease was first identified. While all of
the outbreaks were based in remote rural areas the virus has twice made
it to Kinshasa, the capital of 10 million people, but was effectively
contained.

Mbandaka is an hour's flight from Kinshasa and several days' travel by barge.

There
is no specific treatment for Ebola. Symptoms include fever, vomiting,
diarrhea, muscle pain and at times internal and external bleeding. The
virus can be fatal in up to 90 per cent of cases, depending on the
strain.

NIAID/NIH

There is no specific treatment for Ebola. Symptoms include
fever, vomiting, diarrhoea, muscle pain and at times internal and
external bleeding. The virus can be fatal in up to 90 per cent of cases,
depending on the strain.

Ebola patients slip out of Congo hospital as medics try to control outbreak

BANDAKA, Democratic Republic of Congo (Reuters) - Three patients
infected with the Ebola virus slipped out of an isolation ward at a
hospital in the Congolese city of Mbandaka, health officials said, as
medics raced to stop the deadly disease from spreading in the busy river
port.

The cases represent a setback to costly efforts to contain the virus,
including the use of an experimental vaccine, and show efforts to stem
its spread can be hampered by age-old customs or scepticism about the
threat it poses.

Two patients left the hospital on Monday night
with the help of family members, then headed to a church, the World
Health Organization’s spokesman in Congo, Eugene Kabambi, told Reuters.

One
died at home the next day and was buried with the help of medical
charity Medecins Sans Frontieres (MSF). The other was sent back to
hospital and died that night, Kabambi said.

Health Ministry sources, who asked not to be named, said two police officers had been deployed to help track them down.

Another patient who was close to being discharged left on Sunday evening but was later found, Kabambi said.

The
WHO and MSF said they could not force patients to stay in hospital but
hoped that growing awareness of the disease and its risks would convince
people to follow medical advice.

“This is a hospital. It’s not
a prison. We can’t lock everything,” Henry Gray, the head of the MSF
mission in Mbandaka, told Reuters.

WHO spokesman Tarik Jasarevic said health workers had redoubled
efforts to trace contacts with the patients. Health workers have drawn
up a list of 628 people who have had contact with known cases who will
need to be vaccinated.

“It is unfortunate but not unexpected,”
he said. “It is normal for people to want the loved ones to be at home
during what could be the last moments of life.”

The report came
as another WHO official warned that the fight to stop Democratic
Republic of Congo’s ninth confirmed outbreak of Ebola had reached a
critical point.

“The next few weeks will really tell if this
outbreak is going to expand to urban areas or if we’re going to be able
to keep it under control,” WHO’s emergency response chief, Peter Salama,
said at the U.N. body’s annual assembly. “We’re on the epidemiological
knife edge of this response.”

KINSHASA FEARS

Health officials are particularly concerned
by the disease’s presence in Mbandaka, a crowded trading hub upstream
from Kinshasa, a city of 10 million people. The river runs along the
border with the Republic of Congo.

The WHO said health officials
received an alert on Wednesday from Kinshasa’s main hospital, but the
health ministry said later that it was a false alarm.

The
outbreak, first spotted near the town of Bikoro, about 100 km (60 miles)
south of the city, is believed to have killed at least 27 people so
far.

The WHO said health workers were following up on three
separate transmission chains for cases in Mbandaka’s Wangata
neighborhood - one linked to a funeral, one to a church and another to a
rural health facility.

“It’s really the detective work of epidemiology that will make or break the response to this outbreak,” Salama said.

The
disease was first discovered in Congo in the 1970s. It is spread
through direct contact with body fluids from an infected person, who
suffers severe bouts of vomiting and diarrhea.

More than 11,300
people died in an Ebola outbreak in the West African countries of
Guinea, Liberia and Sierra Leone between 2013 and 2016.

WHO: DRC Ebola outbreak on a 'knife's edge' as urban cases rise

Efforts under way in Democratic Republic of Congo in bid to prevent Ebola outbreak spreading across borders.

An outbreak of the deadly Ebola virus in https://www.aljazeera.com/topics/country/posting_under_country.html" rel="nofollow - Democratic Republic of Congo has the clear "potential to expand" as the number of confirmed cases continues to rise, the World Health Organization warned.

Health workers' response is on an "epidemiological knife's edge" after the number of people stricken with https://www.aljazeera.com/topics/subjects/ebola.html" rel="nofollow - Ebola in the DRC rose to 28 since an outbreak was https://www.aljazeera.com/news/2018/05/cases-ebola-confirmed-democratic-republic-congo-180508142327264.html" rel="nofollow - detected earlier this month, said WHO Deputy Director Peter Salama, in comments made on Wednesday at a conference in Geneva, Switzerland.

Seven of the confirmed cases were https://mailchi.mp/aa52b8ea3d73/ebola_rdc_22mai" rel="nofollow - in urban settings .

"The next few weeks will really tell if this
outbreak is going to expand to urban areas or if we're going to be able
to keep it under control," Salama said.

The average fatality rate among those infected with Ebola, which has no proven cure, is about 50 percent, http://www.who.int/en/news-room/fact-sheets/detail/ebola-virus-disease" rel="nofollow - according to WHO.

DRC's most recent Ebola outbreak - its ninth since the disease was first identified in 1976 - initially appeared to be confined in a rural setting near the town of Bikoro, in the central African nation's northwestern Equateur Province.

But a https://www.aljazeera.com/news/2018/05/drc-ebola-outbreak-enters-phase-urban-case-confirmed-180517153845054.html" rel="nofollow - confirmed instance of the virus last week in the city of Mbandaka, home to 1.2 million people and about 150km away from Bikoro, plunged the ongoing crisis into a "new phase", the DRC's Health Minister Oly Ilunga https://www.aljazeera.com/news/2018/05/drc-ebola-outbreak-enters-phase-urban-case-confirmed-180517153845054.html" rel="nofollow - said last week.

Twenty-seven people have died and at least 58 others in DRC's northwest have shown Ebola symptoms since it was identified on May 8, https://mailchi.mp/aa52b8ea3d73/ebola_rdc_22mai" rel="nofollow - according to the health ministry.

Health ministry spokeswoman Jessica Ilunga said the figures amounted to "the normal evolution of an outbreak".

"As soon as you have a few confirmed cases, the persons who
have been in contact with them are at risk. We knew there was a risk of
more cases coming in," Ilunga told Al Jazeera.

"What we are trying to do first is contain the outbreak so that it doesn't spread towards other urban centres in the DRC."

Regional response

On Wednesday, https://www.aljazeera.com/topics/organisations/world-health-organisation.html" rel="nofollow - WHO said it would work with nine countries neighbouring DRC in a bid to prevent the virus spreading across borders.

Matshidiso Moeti, WHO director for Africa, told the conference
Central African Republic and Republic of Congo were the organisation's
top priority countries because of their proximity.

Efforts to detect and stem a possible cross-border spread would also
be rolled out in Angola, Burundi, Rwanda, South Sudan, Tanzania, Zambia
and Uganda, Moeti said.

The WHO has http://www.who.int/csr/don/23-may-2018-ebola-drc/en/" rel="nofollow - sent 7,540 experimental vaccines to DRC so far. It will send another 8,000 doses, made by pharmaceutical firm Merck, over the next few days.

Though unlicensed, the experimental vaccine proved effective when used in trials in West Africa between 2013-2016 during an Ebola outbreak, which killed about 11,300 people as it surged through Guinea, Sierra Leone, and Liberia.

'Break the transmission chain'

Ilunga said the vaccinations were a vital part of the DRC's strategy to combat the latest emergence of the disease.

"Ebola has a 21-day incubation period, so as soon as you have
confirmed cases you know that in the following three weeks more cases
might appear," she told Al Jazeera.

"That's why vaccination is really important in this Ebola response,
simply because it will allow us to vaccinate and protect the circles of
people who were in contact with those who were, or are, infected and
break the disease's transmission chain."

Ebola, which can cause multiple organ failure, is passed from human
to human by contact through the mouth, nose, or broken skin with blood
or other bodily fluids of those infected.

Congo Faces Obstacles to Fighting Ebola Outbreak

Nine new suspected cases of Ebola were reported in the northwestern https://www.bloomberg.com/quote/45441Z:US" rel="nofollow - Democratic Republic of Congo
as authorities tackling the outbreak face challenges including
resistance by local communities and multiple chains of transmission.

Fifty-eight
cases, including 30 confirmed and 14 probable, have been registered
since the outbreak was declared on May 8, Congo’s Health Ministry said
in a statement Thursday. Of the nine new suspected cases, three are in
Mbandaka, a provincial capital of 1.2 million habitants where four cases
have so far been confirmed. Twenty-seven people have died, according to
the https://www.bloomberg.com/quote/0751538D:SW" rel="nofollow - World Health Organization .

A motocycle drives past the entrance of the Wangata Reference Hospital in Mbandaka May 20, 2018.

Photographer: JUNIOR KANNAH/AFP

Congo’s
latest Ebola outbreak was first identified around the remote town of
Bikoro, 150 kilometers (93 miles) from Mbandaka. The detection of the
virus in an urban center connected by busy river routes to Congo’s
capital, Kinshasa, home to about 12 million people, as well as cities in
the Republic of Congo and https://www.bloomberg.com/quote/3742943Z:ZC" rel="nofollow - Central African Republic , has fueled concerns the disease could spread more widely.

On Monday, the Health Ministry and WHO launched a “ring
vaccination” campaign in Mbandaka and Bikoro with the still-unlicensed
rVSV-ZEBOV treatment, whose manufacturer, Merck & Co., has donated
7,540 doses that arrived in Congo last week. Another 8,000 doses will be
made available, the WHO said.

Vaccination Plans

Health
professionals who’ve been exposed to confirmed cases, as well the
patients’ direct and indirect contacts, will be offered the vaccination.
Over 600 people have been traced, the WHO said Wednesday.

This
week, three people confirmed to be carrying Ebola were removed by their
families from an isolation ward in Mbandaka, the Health Ministry said.
Two have died while one has returned to hospital and is under
observation.

“All efforts were made by staff to convince the
patients, as well as their families, to not leave the center,” but
“Ebola treatment centers are not prisons,” the ministry said. “Even in
an epidemic period, health professionals have the duty to respect the
will and dignity of patients.”

“We don’t want to criminalize patients because if we
criminalize people, they hide,” he said. At the same time, medical
organizations are working to ensure that “the families and the patients
understand what’s going on, that they understand the best chance of a
full recovery is in a center where they can be looked after.”

Community Resistance

Health
workers were unable to take samples from a dead person in Bikoro
“because of the resistance of the community,” the Health Ministry said.
The fatality was accordingly classified as a probable case of Ebola.

There was a “lot of fear and confusion” about Ebola in the affected communities, the ministry said.

Medical
teams in Mbandaka are investigating three separate transmission chains
-- one associated with a funeral in Bikoro, another linked to a health
center near Bikoro and the third related to a church service.

“Each
one has the potential to expand if not controlled,” WHO Deputy
Director-General for Emergency Preparedness and Response Peter Salama
said Wednesday at a briefing in Geneva. “It’s the detective work of
epidemiology which will make or break the response to this outbreak.”

GENEVA/KINSHASA (Reuters) - Two dying Ebola patients were spirited out
of a Congo hospital by their relatives on motor-bikes, then taken to a
prayer meeting with 50 other people, potentially exposing them all to
the deadly virus, a senior aid worker said on Thursday.

Both patients were vomiting and infectious and died hours after the
prayer session in the river port city of Mbandaka, Dr. Jean-Clement
Cabrol, emergency medical coordinator for Medecins Sans Frontieres
(Doctors Without Borders), said.

Democratic Republic of Congo is
racing to contain an outbreak of the disease which spreads through
contact with infected bodily fluids including vomit and sweat.

The
Health Ministry said late on Thursday that a new case had been
confirmed in the town of Bikoro and another in the nearby village of
Iboko, where the epidemic is thought to have started.

This brought the total number of confirmed cases to 31, it said in a statement, out of 52 suspected cases.

Congo’s
ninth recorded outbreak of the disease is thought to have killed at
least 22 people so far, according to government figures released on
Wednesday - lower than the last estimate of 27, after some of those
deaths turned out not to be Ebola.

“The
escape was organized by the families, with six motorcycles as the
patients were very ill and couldn’t walk,” Cabrol told a news briefing
in Geneva after returning from the affected region.

“They were
taken to a prayer room with 50 people to pray. They were found at two in
the morning, one of them dead and one was dying. So that’s 50-60
contacts right there. The patients were in the active phase of the
disease, vomiting.”

The patients got out of the isolation ward on
Monday. Earlier reports did not give details of the escape or where
they went afterwards. A third patient who left the ward survived.

Health
officials started trying to trace the motorcycle drivers and other
people who came into contact with the patients as soon as the escape was
reported, Dr. Peter Salama, head of emergency response at the World
Health Organization (WHO), told Reuters on Thursday.

“From
the moment that they escaped, the (health) ministry, WHO and partners
have been following very closely every contact,” he said.

“HARD TO PREDICT”

WHO’s
three-month budget for the crisis has been doubled to $57 million to
carry out a complex operation in a remote, forested area, Salama said.

“All
it takes is one sick person to travel down the Congo River and we can
have outbreaks seeded in many different locations ... that can happen at
any moment. It’s very hard to predict,” he said, referring to the river
linking the trading hub of Mbandaka to the capital Kinshasa, whose
population is 10 million.

“It is going to be at least weeks and more likely months before we get this outbreak fully under control,” Salama said.

There
have been major advances in medical treatment of the virus since it
ravaged West Africa in 2014-2016, including the use of an experimental
vaccine to protect medical staff.

But local skepticism about the dangers and the need to isolate infected patients continue to complicate efforts to contain it.

In
past outbreaks, mourning relatives have caught the hemorrhagic disease
by touching the highly contagious bodies of dead loved ones, sometimes
by laying hands on them to say goodbye.

Children must be at heart of response to Ebola outbreak in Democratic Republic of the Congo – UNICEF

25 May 2018

KINSHASA/DAKAR/GENEVA/NEW YORK, 25 May 2018 – Children
continue to be at risk and are affected by the ongoing Ebola outbreak in
the Democratic Republic of the Congo (DRC), making it essential that
their health and wellbeing are prioritized in the response.

“Schools are crucial for engaging children and their communities in the
fight against Ebola,” said Dr. Gianfranco Rotigliano, UNICEF
Representative in the DRC, traveling back from the affected region.
“That’s why UNICEF is putting in place measures to minimize the risk of
transmission in schools, including temperature taking and handwashing.”

UNICEF is scaling up prevention efforts in schools across all three
affected health zones. This includes on-going efforts to install hand
washing units in 277 schools and supporting awareness raising activities
reaching more than 13,000 children in Mbandaka, Bikoro and Iboko.

UNICEF is also concerned about the wellbeing of children with family
members who have contracted the disease. “Children whose parents or
caregivers die of Ebola or who live in isolation because they had
contact with an infected person, need psychosocial support to help them
cope,” said Dr. Rotigliano.

Previous Ebola outbreaks have demonstrated the need for social workers
to identify and assist vulnerable children. Twenty-two psychosocial
agents trained by UNICEF and its partners are providing assistance to
families that are affected by the Ebola outbreak, while UNICEF is also
supporting 23 families and their children who have relatives infected
with Ebola by supplying household kits and food rations.

UNICEF continues to work closely with communities to promote behaviors
that help stop transmission, such as safe burials and hand-washing. The
children’s agency is engaging in dialogue with community leaders,
conducting outreach campaigns and supporting door-to-door awareness
raising campaigns. In Mdandaka, 706 community actors were identified and
are being deployed for Ebola prevention communication and community
social engagement.

It is now three weeks since the ebola outbreak was announced publically ( http://www.avianflutalk.com/ebola-again_topic37320_page1.html" rel="nofollow - http://www.avianflutalk.com/ebola-again_topic37320_page1.html ) and four weeks since it started. Vaccinatins are only scheduled to strt tomorrow ( https://www.independent.co.uk/news/world/africa/ebola-outbreak-congo-latest-vaccination-mbandaka-bikoro-iboko-who-a8370921.html" rel="nofollow - https://www.independent.co.uk/news/world/africa/ebola-outbreak-congo-latest-vaccination-mbandaka-bikoro-iboko-who-a8370921.html ).

There are two possible ways to look at this: Should one be amazed that it all happened so quickly? Or should one mourn those for whom it came too late and slate the WHO for procrastination?

Ebola among semi-tribal people spreads like a fire and I know the vaccine arrived in the DRC a week ago, so I favour the former.

Washington: US researchers have started the
first-in-human trial evaluating an experimental treatment for Ebola
virus disease, the National Institutes of Health (NIH) clinical centre
said in a statement

The
Phase 1 clinical trial, named as VRC 608, is examining the safety and
tolerability of a single monoclonal antibody called MAb114, developed
from an Ebola survivor.

Investigators aim to enroll between 18 and 30 healthy volunteers aged
18 to 60. The trial will not expose participants to Ebola virus.

"We hope this trial will establish the safety of this experimental
treatment for Ebola virus disease—an important first step in a larger
evaluation process," said Anthony S Fauci, director at the National
Institute of Allergy and Infectious Diseases (NIAID) in Maryland, US

"Ebola is highly lethal, and reports of another outbreak in the DRC
(Democratic Republic of Congo) remind us that we urgently need Ebola
treatments.

First discovered in humans in 1976 in the DRC, the largest outbreak,
occurred in West Africa from 2014 to 2016. It caused more than 28,600
infections and more than 11,300 deaths, according to the World Health
Organization(WHO).

In May 2018, the DRC reported new Ebola outbreak. While there are no
licensed treatments available for Ebola virus disease yet, multiple
experimental therapies are being developed.

There have been rumours of the disease spreading to Mubende. This is publically refuted by The Ugandan government. Source and Full article: https://reliefweb.int/report/uganda/press-statement-rumoured-ebola-outbreak-mubende-district" rel="nofollow - https://reliefweb.int/report/uganda/press-statement-rumoured-ebola-outbreak-mubende-district

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: May 28 2018 at 3:46am

The Daily Express (we call it the distress) is claiming the outbreak is out of control.

It is a bank holiday here, so all the kids are out of school; consequently my internet connection is horrendous! As a result, I can't post the article. GRRRR!!! Anyway, here is the link: https://www.express.co.uk/news/world/965899/ebola-crisis-outbreak-out-of-control-virus-kills-dozens-democratic-republic-of-congo" rel="nofollow - https://www.express.co.uk/news/world/965899/ebola-crisis-outbreak-out-of-control-virus-kills-dozens-democratic-republic-of-congo

-------------“The point of modern propaganda isn’t only to misinform or push an agenda. It is to exhaust your critical thinking, to annihilate truth.” Gary Kasparov

Posted By: Technophobe
Date Posted: May 30 2018 at 5:32am

More regions to be vaccinated, experimental drugs to be tried in Congo Ebola outbreak

By Meera Senthilingam, CNN

Updated 1448 GMT (2248 HKT) May 29, 2018

(CNN)More
than 400 people have been vaccinated and more than 800 contacts traced
in the city of Mbandaka in the Democratic Republic of Congo.

Use
of the experimental vaccine, known as rVSV-ZEBOV, will now spread to
the more rural regions of Iboko and Bikoro where the majority of cases
have occurred.

Vaccination began in the urban
setting of Mbandaka to "prevent an urban outbreak" as well as further
spread along the nearby Congo river, to reduce "risk through the
interior of DRC and surrounding countries," Dr. Peter Salama, the deputy
director-general of the World Health Organization's Health Emergencies
Program said Tuesday.

He confirmed
the outbreak spread to Mbandaka after two brothers visited Bikoro to
attend a funeral and traveled back to the city.

"Mbandaka is relatively safeguarded at
the moment," he said, adding that officials "haven't seen an explosive
increase in cases" and the teams have reason to "cautiously optimistic."

There
have been 54 cases of Ebola reported in Congo, including 25 deaths.
Thirty-five of those case have been confirmed with laboratory tests.

Salama
said 47 of the cases were in the more rural regions of Bikoro and Iboko
where control efforts will now be focused. "That's where the next phase
of vaccination must go."

The
vaccine is proving to be a very acceptable intervention to the community
in Mbandaka, Salama said. "There are no reports of refusal of the
vaccination."

"Over 90% of eligible
people are getting vaccinated," said Dr. Michael Ryan, WHO assistant
director-general for Emergency Preparedness and Response, highlighting
that this is a strong coverage rate for any vaccine.

health worker prepares an Ebola vaccine to administer to health workers during a vaccination campaign in Mbandaka, Congo.

More than 900 contacts are being followed in Congo, and the number is likely to increase.

The
Ebola vaccine being provided has been shown to be safe in humans and
highly effective against the Ebola virus, according to the WHO. A https://edition.cnn.com/2016/12/22/health/ebola-vaccine-study/index.html" rel="nofollow - 2016 study found
it to be 100% effective in trials in Guinea in coordination with the
country's Ministry of Health after the 2014-15 outbreak.

Therapeutics to be tried

Five
experimental drugs to treat Ebola virus disease, including ZMapp and
Remdesivir, have now arrived in the country and will be trialed under
strict experimental research protocols, Salama said.

This means they will have to be used as part of a clinical trial, with ethical review and informed patient consent.

Officials expect to get formal approval for delivery in the coming days.

WHO
officials hope to introduce the life-saving therapies to patients, but
their use will require sophisticated monitoring. Some of the treatments
require IV infusion, while others require daily assessment of liver and
kidney function, according to Ryan.

In
2014, ZMapp became known when it was used to treat two American
missionary workers, Dr. Kent Brantly and Nancy Writebol, who contracted
Ebola in Liberia. Prior to that, the experimental drug had been tested
only in monkeys.

This is "not a
simple effort to do this kind of trial in this kind of environment,"
said Salama. But "if we don't learn now we'll never know which drugs to
use in this situation."

Vaccination,
therapeutic and control efforts have and will be carried out through
partnerships between WHO, the International Federation of the Red Cross
and Red Crescent Societies, Medecins sans Frontieres (Doctors Without
Borders) and many other NGOs on the ground in Congo.

Control efforts will expand to four more provinces considered to be at risk, the IFRC confirmed.

Ebola
virus disease, which most commonly affects people and nonhuman primates
such as monkeys, gorillas and chimpanzees, is caused by one of five
Ebola viruses. On average, about 50% of people who become ill with Ebola
die.

The first human outbreaks of
Ebola occurred in 1976, one in the north of what is now Congo and in the
region that is now South Sudan.

Humans
can be infected by other humans if they come in contact with bodily
fluids from an infected person or contaminated objects from infected
persons. Humans can also be exposed to the virus, for example, by
butchering infected animals.

West
Africa experienced the largest recorded outbreak of Ebola over a
two-year period beginning in March 2014; a total of 28,616 confirmed,
probable and suspected cases were reported in Guinea, Liberia and Sierra
Leone, with 11,310 deaths, according to the WHO.

WHO 'Cautiously Optimistic' on Ebola Outbreak

May 30, 2018 -- The United Nations' World Health Organization
on Tuesday said it was "cautiously optimistic" that efforts to slow the
spread of https://www.webmd.com/a-to-z-guides/ebola-fever-virus-infection" rel="nofollow - Ebola in a Congolese city were working.

There are still cases occurring in more remote areas,
however, the WHO said, with a total of 35 confirmed cases, 12 of which
have been fatal.

So far, more than 400 people have received an experimental https://www.webmd.com/a-to-z-guides/video/reece-vaccine-development" rel="nofollow - Ebola vaccine that's never before been used in an emerging outbreak, the Associated Press reported.

Ebola outbreak response shifts to remote DRC hot spots

May 29, 2018

Officials from World Health Organization (WHO) today said they're
cautiously optimistic about curbing the spread of Ebola in the city
Mbandaka, Democratic Republic of the Congo (DRC), adding that the next
phase of the outbreak response will focus on two remote hot spots in
Bikoro and Iboko, where most of the cases have been reported.

At a
briefing in Geneva today live-streamed on the WHO's Twitter feed,
health officials also said DRC's health ministry is finalizing protocols
for testing five therapeutic treatments and that a trial of a second
experimental Ebola vaccine—a prime-boost regimen developed by Johnson
& Johnson—may take place in the outbreak setting.

Peter
Salama, MD, the WHO's deputy director-general of emergency response,
said that, as of May 27, 54 Ebola cases have been reported. The number
includes 35 confirmed, 13 probable, and 6 suspected cases. So far 25
deaths have been reported.

Salama said the updated numbers add one
suspected case in Wangata health zone, which is in Mbandaka. Tests have
ruled out Ebola in three suspected cases, one from Ntondo health zone.
Response teams are monitoring more than 900 contacts in the DRC's three
hot spots.

Response in remote epicenters

Of the outbreak's
54 cases, 47 are from Bikoro and Iboko, Salama said. "That's where our
priorities must be going forward." He said on Twitter yesterday that the
WHO surged more staff over the weekend to respond to reports of
increasing cases in Iboko.

More than 400 people have been
immunized in a ring vaccination campaign in Mbandaka involving Merck's
experimental VSV-EBOV vaccine that began on May 21, targeting contacts
of Ebola cases, plus contacts of contacts. He said besides the city's
large size, the initial response centered on the area because of the
risk of spread to other parts of the DRC as well as two neighboring
countries, the Republic of Congo and the Central African Republic.

Vaccination
in the city went very smoothly, and so far there haven't been any
reports of vaccine refusal, Salama said, adding that vaccinators have
reached about 90% of the contacts targeted for immunization.

Though
there is a 10-day window after vaccination before immunity kicks in, he
said there hasn't been an explosion of cases in the city, a positive
development that's part of what's fueling cautious optimism. Salama said
there are three transmission chains in Mbandaka: one involving brothers
who attended a funeral in Bikoro, one linked to a patient who visited a
health center in Bikoro, and one who attended a community church
gathering.

Now, it's time to battle the outbreak at its source, in Bikoro and Iboko, he said.

Michael
Ryan, MD, the WHO's assistant director-general for emergency response,
who just returned from the outbreak region, spoke of the huge logistical
challenging in laying the groundwork for the response in the remote
settings where most of the illnesses are occurring, but he said he is
encouraged by the response he saw to the vaccination campaign in
Mbandaka. "It's the first time in my experience where walking into
villages with the vaccine teams you see hope and not terror," he said.

Doctors
Without Borders (MSF) said today that it started vaccinating healthcare
workers yesterday in Bikoro and that immunization will be offered to
contacts of patients as part of the ring vaccination approach.

The group said the vaccine is one element of a larger strategy to control the spread of Ebola.

Micaela
Serafini, MD, MPH, MSF's medical director in Geneva, said the group
will be closely monitoring people who are voluntarily vaccinated and
that, based on results in Guinea's outbreak, officials are confident
about its use in the current outbreak. "The results of the trial suggest
that the vaccine will present a real benefit to people at high risk of
contracting Ebola, protecting them against the infection," she said.

Salama said vaccination is slated to begin this week in Iboko.

Opportunity to test treatments

The
DRC government is eager to begin using experimental treatments in Ebola
treatment units, and Salama said the programs and their companion
clinical trials will likely begin in the coming days. They include ZMapp
(a monoclonal antibody cocktail), Remdesivir (an antiviral), Regeneron
(a monoclonal antibody treatment), favipiravir (a small-molecule
antiviral), and a monoclonal antibody known as 114.

He said that
doing clinical trials, especially in the remote settings, will be a
challenge, given that some of the drugs involved intravenous
administration over 6 to 12 hours and daily assessment of kidney and
liver function.

Salama said the trials, done under the auspices of
the health ministry, will, it is hoped, test the efficacy of all five
drugs and assess how they compare to each other.

"If we don't use the opportunity to learn in this situation, we'll never be able to know which is better," he said.

Research on a second vaccine?

Salama
said one of the critical questions researchers hope to answer with
current trials under way as part of ring vaccination with VSV-EBOV is
duration of protection. He said data from the trial in Guinea suggest
the vaccine's protection lasts well over a year, and health officials
suspect it might last much longer than that.

He said officials are
exploring, along with the DRC government, if there's an opportunity to
test whether another vaccine that works in a different way has the
potential to protect for an even longer period.

The second vaccine
approach, part of a prime-boost strategy, involves a dose of the
adenovirus vectored Ad26.ZEBOV developed by Johnson & Johnson and a
dose of MVA-BN-Filo from Bavarian Nordic.

New research suggests that we might be able to foresee when and
where the next Ebola outbreak will occur if we take a close look at the
migratory patterns of bats.

You are all probably aware of this theory, but if you want the rest it is at: https://www.medicalnewstoday.com/articles/321909.php?utm_source=newsletter&utm_medium=email&utm_campaign=weekly" rel="nofollow - https://www.medicalnewstoday.com/articles/321909.php?utm_source=newsletter&utm_medium=email&utm_campaign=weekly

-------------Absence of proof is not proof of absence.

Posted By: Technophobe
Date Posted: June 01 2018 at 3:12pm

As Aid Workers Move to the Heart of Congo’s Ebola Outbreak, ‘Everything Gets More Complicated’

Aiming
to squelch an Ebola outbreak that has infected 54 people, killing
almost half of them, aid workers in the Democratic Republic of the Congo
have begun giving an experimental vaccine to people in the rural region
at the epicenter of the outbreak.

Epidemiologists
working in the remote forests have not yet identified the first case,
nor many of the villagers who may have been exposed. Investigators will
need to overcome extreme logistical hurdles to reconstruct how the virus
was transmitted, vaccinate contacts and halt the spread.

“For
an epidemic to be under control, you need a clear epidemiological
picture,” said Dr. Henry Gray, the emergency coordinator for Doctors
Without Borders.

“If you don’t know
the stories of the people involved — who their families were, what their
jobs were, where they went to weddings and funerals — then you don’t
know the epidemic.”

Almost
500 people received the experimental vaccine, VSV-EBOV, last week
around Mbandaka, a riverfront city of more than 1.5 million people where
four Ebola cases have been confirmed.

Mbandaka
is a priority because it is a traffic hub. The Republic of the Congo
lies just across the Congo River, and Kinshasa, Congo’s capital of 10
million, is less than 500 miles downstream.

Aid
workers are using the ring method: The vaccine is given to groups of
people in contact with each Ebola case, such as family caregivers, as
well as the contacts of those contacts.

About
7,500 doses are available to vaccinate 50 rings of 150 people each,
according to Dr. Peter Salama, the deputy director-general for emergency
response at the World Health Organization. An additional 8,000 doses
will follow.

The
W.H.O. is monitoring more than 900 contacts throughout Équateur
province. As the vaccination program expands to the Bikoro and Iboko
communities, where most cases have been reported, teams are relying on
contact tracing to identify the most urgent recipients.

“This is where everything gets more complicated,” saidChiran Livera, the operation leader in Congo for the International Federation of Red Cross and Red Crescent Societies.

The
villages surrounding Bikoro and Iboko are among the most isolated and
densely wooded pockets of Congo. Aid workers must use motorbikes to
navigate cratered dirt roads that flood during the rainy season. Maps of
some regions are incomplete, and vast gaps in cellular service thwart
efforts to report data to central operations.

“Following
the virus’s narrative may sounds easy to do on a suburban street
outside Chicago,” said Dr. Salama. “But when you’re traveling hundreds
of kilometers in a forest by motorbike to find each person, that’s very
different epidemiological work.”

If
the outbreak worsens, a second vaccination may be offered to health
workers. That vaccine, developed by Johnson and Johnson, requires two
doses and would take longer than VSV-EBOV’s seven to 10 days to become
effective — but may protect health workers for several years.

The
Congolese Ministry of Health is planning to deploy up to five
experimental treatments, though the two most highly recommended by the
W.H.O. may prove impractical in a remote setting.

ZMapp,
a cocktail of three antibodies used in West Africa, must be given in
multiple doses and must be refrigerated. Remdesivir, a drug developed by
Gilead Sciences, requires intensive monitoring of liver and kidney
function — nearly impossible for treatment centers without electricity,
running water or standard equipment.

Another
option, called MAb114, began safety trials earlier this month. Made
from the antibodies of an Ebola survivor, it can be crystallized and
reconstituted with saline-like fluids in the field.

“These are all investigative products,” Dr. Salama said. Vaccine makers
have struggled to show efficacy without live Ebola cases in which to
test their drugs. “Many consider this outbreak their chance to prove
themselves,” he said.

Drug companies are not alone in that mission.

The
W.H.O.’s emergency committee gathered 10 days after the Congolese
government notified the organization of an Ebola case, a stark contrast
to the West African epidemic in 2014, when the group did not convene
until almost 1,000 people had died.

Since
May 8, the W.H.O. has sent 156 technical experts to the region. A
mobile laboratory has been set up to expedite case confirmations in
Bikoro; another is planned for Mbandaka. A cellular tower has been
erected in Mbandaka to help workers trace people who may have been
infected throughout the region.

The
W.H.O. has more than doubled its budget request to $56 million from $26
million to account for the possibility of the virus may reach an urban
setting.

“The biggest problem of
2014 was that there had never been an Ebola epidemic before,” said Ron
Klain, the White House’s Ebola response coordinator for West Africa.
“This time, there is an intensity, a focus, a pace. No one is
underestimating the risk, and that alone is a big advantage.”

Another
advantage is context: Unlike West Africa, Congo has experienced eight
previous Ebola outbreaks since the virus was identified in 1976. Aid
workers who arrived in Kinshasa this month found pre-established
surveillance protocols, according to Mr. Livera.

The
W.H.O.’s strategy assumes the virus will ultimately infect 100 to 300
people. Each rural case may infect 10 contacts, and each urban case may
infect 30. Response activities may continue into July, according to a http://www.who.int/emergencies/crises/cod/DRC-ebola-disease-outbreak-response-plan-28May2018-ENfinal.pdf?ua=1&ua=1" rel="nofollow - revised plan released May 27.

Until
investigators identify the index case, it is impossible to discern
whether the first patient detected in April was truly the first human
case or the hundredth, according to Dr. Gianfranco Rotigliano, the
regional director of Unicef. Until then, it is impossible to quantify
the crisis.

“These are the early days
of the outbreak,” Dr. Salama said. “There can be lulls. We’ve seen that
before. But there only needs to be one event — a super-spreader, like a
funeral — to cause an explosion.”

Ebola vaccinations rise in Congo as outbreak takes hold

More than 680 people have received Ebola vaccinations in the three areas
of the Democratic Republic of Congo (DRC) where dozens of cases of the
deadly virus have been confirmed, the country's health ministry has
said.

Health experts are pushing to find contacts of those infected, having already located more than 1,000.

As of Friday evening (GMT), there have been 37 confirmed Ebola cases in the DRC, including 12 deaths.

There are another 13 probable cases, according to the country's health ministry.

Advertisement

Officials from the ministry could be seen on Friday in Mbandaka.

The city of 1.2 million people is the provincial capital of northwest Equateur province.

The officials were registering a young girl, whose parents died from the virus. She is now under UNICEF's care.

Further away, a young boy is
sitting in a chair with a high fever. He is suspected of having been
infected with the virus and has been placed in quarantine as a
precaution.

While nearly 500 people have been vaccinated in Mbandaka since 21 May, ignorance about the virus' existence is still a threat.

"Most people here in Mbandaka
and maybe in Bikoro and elsewhere are still ignorant. They have not yet
understood that Ebola really exists," Dr. Hiller Manzimbo, a hospital
director, told The Associated Press.

Manzimbo was referring, among
others, to Irene Mbwo, the widow of an Ebola victim, who does not
recognise that her husband died from the virus and has refused the
vaccine herself.

"They just told me that he died
of Ebola, but they did not publish his blood results," she told The
Associated Press. "But how can they claim that he died of Ebola, when
they say that those who came in contact with him will see symptoms of
infection within three days, and I told them at the hospital today that I
have been clean for 21 days?" she insisted.

In an Ebola plan released this
week by the World Health Organisation (WHO), the UN's health agency
predicted there could be up to 300 cases in the coming months, noting
there could be three times as many contacts to chase if the virus
spreads in urban, as opposed to rural, areas.

Although WHO officials said
"more than half" of newly confirmed Ebola cases had been previously
identified, a substantial portion of cases are showing up that were not
being monitored, meaning the disease is in some cases spreading
unnoticed.

The WHO also said officials
would likely need more triage, isolation and treatment centres, possibly
including one in the capital, Kinshasa. It said additional aircraft,
helicopters and boats were needed to manage the challenging logistics of
the outbreak and that it might ultimately cost 56 million US dollars to
contain Ebola.

The UN health agency said that
based on an initial assessment of Bikoro, "there is an approximate
movement of over 1,000 people per day by river, road and air at major
points of entry."It recommended that neighbouring countries strengthen
their capacity to identify imported cases of Ebola, including by
implementing exit screening.

The WHO said the risk of spread
to elsewhere in Africa was high but that the risk of global
transmission was low. It added that even though experts had concluded
the outbreak conditions do not currently merit being declared a global
emergency, the situation would be re-evaluated if the epidemic spikes
significantly or if there is international spread.

Ebola outbreak: Case counts, Africa CDC Deploys Teams

In an update on the Ebola Virus Disease (EVD) outbreak in Equateur
Province, Democratic Republic of the Congo (DRC), the case counts as of
June 1 are as follows:

37 confirmed cases, 13 probable and seven suspected for a total of 57 cases, including 25 deaths since early April 2018.

The outbreak remains localized to the three health zones initially affected: Iboko, Bikoro and Wangata.

Since the launch of the vaccination exercise on 21 May 2018, a total
of 682 people have been vaccinated. The targets for vaccination are
front-line health professionals, people who have been exposed to
confirmed EVD cases and contacts of these contacts.

After recruiting and training 18 Congolese volunteers, Africa CDC has
just deployed them to Equateur province to support the response to
Ebola Virus Disease in DR Congo.

The responders, who are former volunteers of the African Union
Support to the Ebola Outbreak in West Africa (ASEOWA) in the 2014-16
outbreak, they also participated in the post-Ebola enhanced surveillance
in the Democratic Republic of Congo in July 2017 in the province of
Bas-Uélé.

In response to the ongoing outbreak of Ebola in the Democratic
Republic of the Congo, WHO in collaboration with the Government of the
Democratic Republic of the Congo, the International Organization for
Migration (IOM), Africa Centres for Disease Control and Prevention
(Africa CDC) and other partners, has developed a comprehensive strategic
response plan for points of entry. The aim of the plan is to avoid the
spread of the disease to other provinces or at the international level.
The plan includes mapping strategic points of entry and the locations of
areas where travellers congregate and interact with the local
population, and therefore are at risk of Ebola virus disease
transmission based on population movement. The plan also includes
implementing health measures at the identified points of entry/traveller
congregation points, such as risk communication and community
engagement, temperature checks, provision of hand hygiene and sanitation
materials, and the development of alert, investigation and referral
procedures.

As of 18 May 2018, a total of 115 points of entry/traveller
congregation points have been listed and mapped along cordon sanitaires
in Mbandaka, Bikoro, Iboko, larger Equateur Province, and Kinshasa. Of
these, some 30 points of entry have been prioritized for in-depth
assessments and for implementing relevant prevention, detection and
control measures. These include major ports and congregation points
along the Congo river, as well as the two airports and the international
port in Kinshasa. Areas of large gatherings such as markets are also
being assessed. Along the Congo river there are many private smaller
ports and points of congregation with a low volume of traffic. Proper
screening cannot be conducted at all 115 points, and the efforts
currently focus on the 30 prioritized points of entries/ traveller
congregation points, as well as on risk communications activities and
community engagement.

Entry and exit screening measures have been implemented at the
Mbandaka airport, as well as in some terminals of the Kinshasa
international airport. These include travel health declaration, visual
observation for symptoms, temperature check and travel health promotion
measures, as well as procedures for referral of suspect cases.

The International Health Regulations Emergency Committee, was
convened by the WHO Director-General on 18 May 2018, and advised against
the application of any travel or trade restrictions to the Democratic
Republic of the Congo in relation to the current Ebola outbreak, as
flight cancellations and other travel restrictions may hinder the
international public health response and may cause significant economic
damage to the affected country (see link below). The Emergency Committee
also advised that exit screening, including at airports and ports on
the Congo river, is considered to be of great importance; however entry
screening, particularly in distant airports, is not considered to be of
any public health or cost-benefit value.

http://www.who.int/news-room/detail/18-05-2018-statement-on-the-1st-meeting-of-the-ihr-emergency-committee-regarding-the-ebola-outbreak-in-2018" rel="nofollow - Statement of the 1st meeting of the International Health Regulations Emergency Committee

WHO is monitoring travel and trade measures in relation to the
current outbreak. As of 28 May, 23 countries have implemented entry
screening for international travellers coming from the Democratic
Republic of the Congo, but there are currently no restrictions of
international traffic in place.

WHO advice

The Emergency Committee convened by the Director-General on 18 May
2018 noted that the Ebola outbreak does not currently meet the
conditions for a Public Health Emergency of International Concern
(PHEIC). The Committee issued comprehensive Public Health Advice , in
particular with regards to the fact that there should be no
international travel or trade restrictions, that neighbouring countries
should strengthen preparedness and surveillance, and that during the
response, safety and security of staff should be ensured, and protection
of responders of national and international staff should prioritised.

WHO has also issued travel advice for international travellers in
relation to the current Ebola outbreak in the Democratic Republic of the
Congo (see link below).

http://www.who.int/ith/evd-travel-advice-final-29-05-2018-final.pdf?ua=1&ua=1" rel="nofollow - WHO
recommendations for international travellers related to the Ebola virus
disease outbreak in the Democratic Republic of the Congo

Travellers going through the exit screening from the Democratic Republic of the Congo

Effective exit screening helps prevent the exportation and spread of
disease to other areas. During exit screening at international airports
and points of entry, travellers will be assessed for signs and symptoms
of an illness consistent with Ebola virus disease, or identified as
contacts potentially exposed to Ebola virus disease.

Travellers with a possible exposure to Ebola virus and who are
sick should postpone international travel and seek immediate medical
assistance if there is a possible exposure to Ebola virus disease;

Any person with an illness consistent with Ebola virus disease
will not be allowed to travel unless the travel is part of an
appropriate medical evacuation (see link below);

Travellers should plan to arrive early at the travel facility and expect delays related to public health screening;

Travellers will be required to complete a Traveller Public Health
Declaration, and these will be reviewed prior to clearance to board;

Temperature measurement will be required, in addition to normal security provisions;

There is a possibility that a person who has been exposed to Ebola
virus and developed symptoms may board a commercial flight or other mode
of transport, without informing the transport company of his/her
status. Such travellers should seek immediate medical attention upon
arrival, mention their recent travel history, and then be isolated to
prevent further transmission. Information of close contacts of this
person on board the aircraft (e.g. passengers one seat away from the ill
traveller on the same flight, including across an aisle, and crew who
report direct body contact with the ill traveller) should be obtained
through collaboration with various stakeholders at points of entry (e.g.
airline reservation system) in order to undergo contact tracing.

Returning travellers

The risk of a traveller becoming infected with Ebola virus during a
visit to the affected areas and developing disease after returning is
extremely low, even if the visit included travel to areas where primary
cases have been reported. Transmission requires direct contact with
blood or fluids of infected persons or animals (alive or dead), all
unlikely exposures for the average traveller (see link below).

There is, however, a risk for health care workers and volunteers,
especially if involved in caring for Ebola virus disease patients. The
risk can be considered low, unless adequate infection prevention and
control measures (such as use of clean water and soap or alcohol-based
hand rubs, personal protective equipment, safe injection practices and
proper waste management) are not followed, including at points of
medical care at ports, airports and ground crossings.

As the incubation period for Ebola is between 2 to 21 days,
travellers involved in caring for Ebola virus disease patients or who
suspect possible exposure to Ebola virus in the affected areas, should
take the following precautions for 21 days after returning:

Stay within reach of a good quality health care facility;

Be aware of the symptoms of infection; and,

Seek immediate medical attention (e.g. through hotline telephone
numbers) and mention their recent travel history if they develop Ebola
virus disease like symptoms.

Tuesday, 05 June 2018 05:51

Doctors Without Borders or Médecins Sans
Frontières (MSF) Southern Africa has launched an appeal to raise funds
to fight the Ebola outbreak in the Democratic Republic of Congo

Ebola
has caused thousands of deaths since the first outbreak in 2013. (Image
source: EU Civil Protection and Humanitarian Aid Operations/Flickr)

MSF said in a statement that 25 people had died since the outbreak
was declared on 8 May, with 35 confirmed cases of Ebola recorded so far.

MSF said it would use funds collected towards care for diagnosed
patients and isolation, outreach activities, follow-up with patients,
activities to inform people about the risks of Ebola and safe burials.

Most of the Ebola cases are in the country's remote Bikoro health
zone, which lacks the healthcare infrastructure to tackle the spread of
Ebola.

The WHO last month reported one confirmed case of Ebola in Mbandaka, a city of 1.2mn.

This is a cause for worry because Mbandaka, which is close to the Congo River, which sees significant regional traffic.

The Ebola virus, which has caused several thousand deaths, is a
communicable viral disease which causes severe bleeding, organ failure
and could lead to death.

The first outbreak of the disease was recorded in Guinea in 2013 and
later spread to Guinea, Liberia, and Sierra Leone, with minor outbreaks
in other regions.

The International Federation of Red Cross and Red Crescent Societies
(IFRC), last month, called for aid to the tune of about US$15.1mn to
support its operations in tackling the Ebola outbreak in the DRC.

The outbreak of Ebola virus disease (EVD) in the Democratic Republic
of the Congo remains active. On 3 June 2018, six new suspected EVD cases
have been reported in Bikoro (5) and Wangata (1) Health Zones. Three
laboratory specimens (from suspected cases reported on 2 June 2018)
tested negative. No new confirmed EVD cases and no new deaths have been
reported since our last situation update on 1 June 2018.

Since the beginning of the outbreak (on 4 April 2018), a total of 56
EVD cases and 25 deaths (case fatality rate 44.6%) have been reported,
as of 3 June 2018. Of the 56 cases, 37 have been laboratory confirmed,
13 are probable (deaths for which it was not possible to collect
laboratory specimens for testing) and six are suspected. Of the
confirmed and probable cases, 25 (50%) are from Iboko, followed by 21
(42%) from Bikoro and four (8%) from Wangata health zones. A total of
five healthcare workers have been affected, with four confirmed cases
and two deaths.

Context

On 8 May 2018, the Ministry of Health of the Democratic Republic of
the Congo notified WHO of an EVD outbreak in Bikoro Health Zone,
Equateur Province. The event was initially reported on 3 May 2018 by the
Provincial Health Division of Equateur when a cluster of 21 cases of an
undiagnosed illness, involving 17 community deaths, occurred in
Ikoko-Impenge health area. A team from the Ministry of Health, supported
by WHO and Médecins Sans Frontières (MSF), visited Ikoko-Impenge
health area on 5 May 2018 and found five case-patients, two of whom were
admitted in Bikoro General Hospital and three were in the health centre
in Ikoko-Impenge. Samples were taken from each of the five cases and
sent for analysis at the Institute National de Recherche Biomédicale
(INRB), Kinshasa on 6 May 2018. Of these, two tested positive for Ebola
virus, Zaire ebolavirus species, by reverse transcription polymerase
chain reaction (RT-PCR) on 7 May 2018, and the outbreak was officially
declared on 8 May 2018. The index case in this outbreak has not yet been
identified and epidemiologic investigations are ongoing, including
laboratory testing.

This is the ninth EVD outbreak in the Democratic Republic of the
Congo over the last four decades, with the most recent one occurring in
May 2017. The outbreak has remained localised to the three health zones
initially affected: Iboko (23 confirmed cases, 2 probable, 5 deaths),
Bikoro (10 confirmed cases, 11 probable, 5 suspected, 17 deaths) and
Wangata (4 confirmed cases, 1 suspected, 3 deaths). As of 31 May 2018, a
total of 880 contacts remain under active follow-up.

'Strong progress' in calming Congo Ebola outbreak: WHO

9 Jun, 2018 4:45am

DAKAR, Senegal (AP) — "Strong
progress" has been made in calming Congo's deadly Ebola outbreak in a
city of 1.2 million and in the rural outpost where the epidemic was
declared one month ago, the World Health Organization said Friday, but
now the focus turns to "some of the most remote territory on Earth."

Health officials expressed cautious optimism as the pace of new cases
has slowed. Congo's health ministry late Thursday announced a new
confirmed Ebola case, bringing the total to 38, including 13 deaths.

The new case is in the remote Iboko health zone in Congo's northwest.
Health workers also have been chasing contacts of those infected in
Mbandaka city, a provincial capital on the heavily traveled Congo River,
and in Bikoro town where the outbreak was declared.

While Ebola's spread to a major city has complicated efforts to track
all contacts of those infected, the presence of the virus in Iboko poses
another world of problems.

The forested terrain is so rough
that even four-wheel-drive vehicles can't reach the area, which has no
electricity, WHO's emergency response chief Peter Salama told reporters
in Geneva. Motorcycles are only now arriving and health workers are
sleeping 15 to 20 people to a tent.

"This is a major logistical and boots-on-the-ground epidemiological
endeavor now," Salama said, adding that work there will go on for weeks.

WHO has vaccinated more than 1,000 people over the past two weeks in
all areas of the outbreak, including health workers who are at high
risk. The virus spreads via bodily fluids of infected people, including
the dead.

"There's been very
strong progress in the outbreak response, particularly in relation to
two of three sites," Salama said. "Phase one, to protect urban centers
and towns, has gone well and we can be cautiously optimistic."

He warned, however, that experts are not in a position to document all
chains of transmission of the virus, so "there may still yet be unknown
chains out there and there may still be surprises in this outbreak."

This is Congo's ninth Ebola outbreak since 1976, when the hemorrhagic fever was first identified.

WHO said it is supporting emergency response and preparedness efforts
by nine neighboring countries. Republic of Congo and Central African
Republic are closest to the outbreak and are highest priority, but Congo
is also bordered by Angola, Burundi, Rwanda, South Sudan, Tanzania,
Uganda and Zambia.

WHO says the Ebola response will cost more than $15.5 million over nine months.

Congo Ebola outbreak: WHO records 62 cases, 27 deaths

Saturday 9 June 2018 - 9:27am

NEW YORK - https://enca.com/africa/who-waiting-for-drc-approval-to-send-unlicensed-ebola-medication" rel="nofollow - World Health Organisation (WHO) experts said they have recorded https://enca.com/africa/fresh-ebola-cases-in-dr-congo-authorities" rel="nofollow - 62 Ebola cases in the Democratic Republic of Congo (DRC) during this latest outbreak, with 38 confirmations and 27 deaths.

Deputy Director-General for Emergency Preparedness and Response of
WHO, Dr Peter Salama reported in Geneva that “very strong progress” in
response to the Ebola outbreak in the DRC, one month after the start of
the diseases.

He said that the first phase – protecting urban centres and towns – “has gone well, and we can be cautiously optimistic.”

“There have been 62 Ebola cases in the DRC during this latest outbreak, with 38 confirmations and https://enca.com/africa/ebola-deaths-continues-in-drc" rel="nofollow - 27 deaths .

“The latest case, confirmed on Thursday, was in the remote Iboko
health zone in the northwest, an indication that the outbreak is
ongoing, he said.

Salama, who just returned from a two-day visit to the DRC said:
“There’s been very strong progress in the outbreak response,
particularly in relation to two of the initial three sites: Mbandaka and
Bikoro”.

Mbandaka, in northwest DRC, has a population of around one
million,and it is the capital of Equateur province, where the small town
of Bikoro also is located.

“We’re cautiously optimistic but there’s a lot of very tough work to
do in phase two before we say that we’re on the top of this outbreak and
we’ve learned the hard way in the past never to underestimate Ebola,”
Salama said.

He said the focus now was on rural isolated communities in the Iboko
health zone which would present logistical and other challenges.

Salama described it as among the most remote territory on Earth,
mainly inhabited by indigenous populations, while WHO currently has 80
staff in the area.

“We’re talking about an enormous logistical effort required to reach
every alert of a case. And then if there is a confirmation of a case,
every contact of those cases,” he explained. (NAN)

In tracking filovirus reservoirs, fruit bats have been implicated for ebola, though apparently no virus has yet been isolated. Since VSV-EBOV is based on VSV, and VSV-Indiana was originally isolated from a cow in July of 1925, the Salmonella connection to Mbandaka links US and UK. Salmonella has been isolated from fruit bats in India: Pteropus.

This links to polio (picornavirus) vaccinations at Mbandaka (formerly Coquilhatville).

Posted By: MikeL
Date Posted: June 12 2018 at 1:59pm

If ebola is vectored by fruit bats, though no virus has yet to be found infecting them, then bat flies are suspect. Nipah virus infects Eidolon dupreanum, though E. helvum is infected by Lagos bat virus, which is the link to HIV-2.

The outbreak of Ebola virus disease (EVD) in the Democratic Republic
of the Congo remains active. One month into the response, there is
cautious optimism about the situation in Bikoro and Wangata (especially
Mbandaka) health zones where the last confirmed EVD case was reported on
16 May 2018. The primary focus of the response has moved from the urban
areas of Equateur Province to the most remote and hard-to-reach places
in Itipo and the greater Iboko Health Zone.

On 10 June 2018, two new suspected EVD cases were reported in Iboko
Health Zone. Thirteen laboratory specimens (from suspected cases
reported previously) tested negative. No new confirmed EVD cases and no
new deaths have been reported on the reporting date. Since 17 May 2018,
no new confirmed EVD cases have been reported in Bikoro and Wangata
health zones, while the last confirmed case was reported in Iboko Health
Zone on 2 June 2018.

Since the beginning of the outbreak (on 4 April 2018), a total of 55
EVD cases and 28 deaths (case fatality rate 50.9%) have been reported,
as of 10 June 2018. Of the 55 cases, 38 have been laboratory confirmed,
14 are probable (deaths for which it was not possible to collect
laboratory specimens for testing) and three are suspected. Of the
confirmed and probable cases, 27 (52%) are from Iboko, followed by 21
(40%) from Bikoro and four (8%) from Wangata health zones. A total of
five healthcare workers have been affected, with four confirmed cases
and two deaths.

The number of contacts requiring follow-up is progressively
decreasing with many completing the required follow-up period. As of 10
June 2018, a total of 634 contacts were under follow up, of which 633
(99.8%) were reached on the reporting date.

Context

On 8 May 2018, the Ministry of Health of the Democratic Republic of
the Congo notified WHO of an EVD outbreak in Bikoro Health Zone,
Equateur Province. The event was initially reported on 3 May 2018 by the
Provincial Health Division of Equateur when a cluster of 21 cases of an
undiagnosed illness, involving 17 community deaths, occurred in
Ikoko-Impenge health area. A team from the Ministry of Health, supported
by WHO and Médecins Sans Frontières (MSF), visited Ikoko-Impenge health
area on 5 May 2018 and found five case-patients, two of whom were
admitted in Bikoro General Hospital and three were in the health centre
in Ikoko-Impenge. Samples were taken from each of the five cases and
sent for analysis at the Institute National de Recherche Biomédicale
(INRB), Kinshasa on 6 May 2018. Of these, two tested positive for Ebola
virus, Zaire ebolavirus species, by reverse transcription polymerase
chain reaction (RT-PCR) on 7 May 2018, and theoutbreak was officially
declared on 8 May 2018. The index case in this outbreak has not yet been
identified and epidemiologic investigations are ongoing, including
laboratory testing.

This is the ninth EVD outbreak in the Democratic Republic of the
Congo over the last four decades, with the most recent one occurring in
May 2017.

There seems no published reports of fruit-bat eating habits in the areas of interest for this latest outbreak. Feline immunodeficiency virus links to big cats and jungle cats such as leopards, linking "cat scratch fever" (Bartonella) to Nipah virus (Paramyxoviridae) and fruit bats:

During rubber-exploiting years in the Congo, the workers slept in wooden cages constructed from available materials, which were not always effective against leopards. Thomas Duncan's ebola med, brincidofovir, is the ether lipid analogue of cidofovir. Cidofovir potently inhibits cytomegalovirus. Congo chevrotain (Tragulus) mothers teach their young to eat the twigs of Pycnanthus, which anti-cytomegalovirus compounds include dihydroguaiaretic acid.

'....inhibited the myristoylation of the proteolytic cleavage of the gag-coded polyprotein Pr53gag to p24 but did not affect the processing of gp160.'

'p. 728: At some time in late 1959 or early 1960, a (polio vaccination) campaign was staged at the large town of Coquilhatville ("Coq," now Mbandaka) in Equateur Province.

p. 738: Equally, we know that one of the last campaigns in the Congo, that at Coquilhatville (Mbandaka), the one that Courtois later hoped to have monitored by the CDC, does not correlate with the early spread of HIV-1, for a retrospective test of 250 sera taken from Mbandaka in 1969 revealed no HIV positives.'

(Hooper, The River: A Journey to the Source of HIV/AIDS)

Posted By: MikeL
Date Posted: June 14 2018 at 10:22am

VSV-EBOV, a Diptera-based vaccine compares with CMV-based vaccines, because some bat fly parasites are blind. Thus, Iboko, for example, links to CMV retinitis:

Edward Hooper (The River) shows Yaounde, Cameroon on the map but does not mention polio at Quesso, and the WHO does not seem to mention it either, or on the internet. Unfortunately, we no longer have the citation for the polio cases at Quesso. Quesso is on the Sangha River at the southernmost tip of Cameroon, which river borders the area that was the origin of the HIV-O subtype. The Sangha connects the Congo below Mbandaka. Yaounde includes the region for the origin of HIV-1. Many animals from southern and southeastern Cameroon end up at the market in Yaounde.

The Ebola outbreak in Congo has been
closely tracked and, so far, well-contained, in stark contrast to the
2014 West Africa outbreak that killed thousands of people.

The Ebola outbreak in the Democratic Republic of the Congo appears to be in its waning days. Despite http://apps.who.int/iris/bitstream/handle/10665/272825/SITREP_EVD_DRC_20180612-eng.pdf?ua=1" rel="nofollow - 28 deaths as of early June ,
health officials are cautiously optimistic that they are bringing the
outbreak under control. So far, it’s a striking turnaround from the 2014
West Africa outbreak, which killed more than 11,000 people in Liberia,
Sierra Leone and Guinea, and traveled as far as Glasgow, Scotland, and
Dallas, Texas.

Despite difficult-to-traverse terrain and local communities’
skepticism of health care workers, from the start of the outbreak,
officials got in front of the disease and kept it in check. Several
factors made the DRC response markedly different than previous
outbreaks, saving countless lives.

1. Long distances between villages and an underdeveloped infrastructure slowed the spread of the disease.

The DRC’s remoteness made it difficult for
health care workers to access affected communities, but it also impeded
the spread of the disease. For the most part, infected individuals did
not leave their communities, and outsiders didn’t come in, greatly
limiting the number of infections. In contrast, in 2014, at the height
of the West Africa epidemic, Ebola spread quickly through densely
populated cities.

The paradox in this containment story is that whereas in 2014 the human was vector, in 2018 the ebola reservoir remains at large despite a vaccine, just as it did in 2014.

Because ebola sequences have been detected in small mammals at Bangui, both polio and HIV coalesce three theories in southeastern Cameroon: SIV-contaminated polio vaccine, SIV-contaminated bush meat, and contaminated reused hypodermic needles for general use).

There is no doubt that polio cases at Quesso are documented, though we cannot retrieve a citation at this time. Quesso is also spelled Ouesso, and a Pubmed search retrieves only one reference:

Thomas Duncan's ebola med, brincidofovir, is an ether-lipid analogue that reveals clues to its synthesis: myristoylation is also documented for HIV-1. Therefore, whereas myristoylation is a lipidation modification (compared with brincidofovir), sumoylation is a post-translational modification.

Thomas Duncan's ebola meds are based on anti-CMV compounds such as cidofovir, which links to anti-CMV compounds of the Tragulus food, Pycnanthus. Thus chevrotains were eating anti-CMV compounds throughout their evolution.

Foot-and-mouth disease virus is a Picornavirus, and the chevrotainian "ghost sequence" reveals an antiviral strategy of the Myristaceae:

In summary, FMDV Lpro has evolved to recognize two specific substrates at two different cleavage sites by providing a deep hydrophobic pocket to interact specifically with residues such as leucine at the P2 site, and subsequently modulating the interaction through subtle requirements at the P1 or P1' sites. Would it not have been easier for the FMDV Lpro to have evolved to recognize a unique cleavage site? This would mean cleaving between L and VP4 at a site containing a P1 Gly and a P1' Arg, as found in the cleavage site of of eIF4GI, or cleaving the eIF4GI between a P1 lysine and a P1' Gly, as found in the polyprotein cleavage site.

The first possibility cannot be an option as the N-terminal region of VP4 contains the recognition signal for myristoylation (GlyAlaGlyXSer); any attempt of the virus to introduce basic residues would lead to an inability to myristoylate VP4 and hence a defect in viral replication. The second option does not seem possible either, as the sequence LeuLys*Gly cannot be found in a position that would allow proteolysis to separate the eIF4GI binding domains for eIF4E and eIF4A.'

There is cautious optimism that a dangerous https://www.statnews.com/2018/05/26/341517/" rel="nofollow - Ebola outbreak
in the Democratic Republic of the Congo is over, the head of the World
Health Organization’s emergency response operations said Thursday.

Transmission of the deadly virus appears to have
stopped — though it is not yet time to pull back on the response
operation, Dr. Peter Salama, deputy director-general for emergency
preparedness and response, told STAT.

“Overall I’d be very confident that we’ve broken
the back of this outbreak,” Salama said, noting that the WHO will
discuss with the DRC government in coming days how long to maintain
response operations and when to think about declaring the outbreak over.

While there have been 28 fatalities due to Ebola,
there hasn’t been a newly confirmed diagnosis since early June. And
while surveillance teams keep finding and testing people who are sick,
time and again tests have shown that what ails them is not Ebola.

Typically infectious disease outbreaks are declared over
when there hasn’t been a new case for two full incubation periods of the
particular disease. Ebola’s incubation period is two to 21 days, so 42
days is the bare minimum. As of Thursday, 19 days had passed without a
new case.

https://www.statnews.com/2018/05/22/ebola-scientists-outbreak/" rel="nofollow -
‘You’re holding your breath’: Scientists who toiled for years on an Ebola vaccine see the first one put to the test

But the WHO is likely to be cautious, particularly in light of the West African Ebola outbreak that ran from late 2013 to 2016.

That epidemic appeared to be coming under control in 2015 and 2016,
and on several occasions the WHO declared the outbreak over in one of
the affected countries. Then a cluster of new cases would be spotted.

Investigation of the new cases brought to light that a phenomenon
previously thought to be mainly a theoretical risk: The Ebola virus
persisted in some survivors for weeks and in some cases even months —
notably in https://www.nejm.org/doi/10.1056/NEJMoa1500306?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov" rel="nofollow - eyeballs and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091350/" rel="nofollow - testicles — often reigniting spread of the disease.

Investigations found most of the new cases were linked to sexual
contact with a survivor; mother-to-infant transmission via breast milk
was seen in one case.

The same kind of risks “mustn’t be underestimated” in the latest
outbreak, said Dr. Jeremy Farrar, director of Britain’s Wellcome Trust,
one of the first entities to step up to help fund this outbreak
response.

“You would hate to declare it over prematurely,” he said, noting that
having to unwind operations and rebuild them later would be difficult
and would undermine morale.

The use of an https://www.statnews.com/2018/05/13/ebola-vaccination-program-could-begin-this-week-in-the-drc/" rel="nofollow - experimental Ebola vaccine in the outbreak may diminish the risk of straggler cases, or even sexually transmitted infections from survivors, however.

The vaccine, being developed by Merck, was offered to health care
workers as well as the contacts of cases — and their contacts — in
what’s called a ring vaccination approach. The idea is to stop spread of
the virus by protecting anyone who might be at risk of contracting it.

Acceptance of the vaccine was astonishingly high — almost everyone
offered a chance to be vaccinated took it. Salama said in nine of 11
vaccination rings, all the people offered the vaccine agreed to be
vaccinated. In the other two rings, 98 percent agreed. “It was really
heartening,” he said.

It is too early to say for sure, but Salama believes the vaccination
effort helped to contain the outbreak, which involved spread in three
locations — the city of Mbandaka, on the Congo River, the town of
Bikoro, and the village of Iboko.

“Just eyeballing the data, the fact that these outbreaks really
stopped in their tracks … to me is suggestive that the vaccination had
some impact,” he said. Salama noted infections dried up despite the fact
that contact tracing — finding people who had been exposed to cases to
monitor them for signs of Ebola — only really got to high levels late in
May. That is about a week after vaccination began in Mbandaka and
around the time it started in Bikoro and Iboko.

The outbreak post-mortems will include an effort to explore the
question more fully, Salama said. Scientists will look at when contacts
of cases were exposed to sick people and then when they were vaccinated
to try to discern if the vaccine may have prevented infections.

“We’ll know more on that when we do more modeling post-outbreak with
the full data set,” Salama said. “But for the regular transmission,
certainly that’s extremely likely. And even [to prevent] sexual
transmission, it’s possible.”

None of the experimental Ebola therapies shipped to DRC ended up
being used in this outbreak. By the time the country’s scientific and
ethics advisory committees had studied the drugs and agreed they would
be administered, there were https://www.statnews.com/2018/06/11/testing-ebola-treatments-outbreak/" rel="nofollow - no patients left to treat .

“It is a lost opportunity,” Salama acknowledged.

But he noted that in a small 2017 outbreak in DRC, the same thing
happened with a proposal to use the experimental vaccine. The groundwork
laid then led to quicker approval of the vaccine this time, he said,
and the review of the experimental drugs in this outbreak could speed
approvals the next time DRC — on its ninth Ebola outbreak — has to fight
this disease. “For next time, I think it will happen much more
quickly,” Salama said.

We (this writer and many quoted authors) are developing a Japanese alphabet (rather than a syllabary). This alphabet will serve to communicate more efficiently in various languages. An example of translational blunders for ebola reporting is here:

www. for Ebola in America and Other Fake Problems Our Leaders Love to Fight

'In 1972, an American doctor, Thomas Cairns doing missionary work in the Congo, cut himself with a scalpel during an autopsy on a patient who had died of ebola -- a disease yet unknown to medical science. He survived because his wife, even under those conditions, treated him with a basic drip.'

This translation is dubious, because it does not mention bananas. The original Russian written by Yulia Latynina of Novaya Gazeta, states:

Correctly, his wife covered it with banana leaves from the hut (roof) placed into a homemade dropper.'

Similarly, Japanese ebola experts assisted the WHO on 20 separate occasions during the Liberia and Sierra Leone ebola outbreak. This is what one usually sees when visiting the Yomiuri news site:

Yomirui Online

http://www.yomiuri.co.jp" rel="nofollow - www.yomiuri.co.jp

This page is in English:

kyoiku.yomiuri.co.jp/2017.3.15eigo_mondai.pdf

'....ebola....The Tokyo-based center will use drones capable of long distances at high speeds in Zambia....Toyama Chemical Co. Ltd. will provide T-705 or Favipiravir, a medicine which is not yet approved for ebola virus disease treatment.'

Drones should be applicable for vector-reservoir studies as well, and an efficient alphabet (rather than the now-existing Japanese syllabary), will assist in speed and efficiency of communication.

The Ministry of Health and WHO continue to closely monitor the
outbreak of Ebola virus disease (EVD) in the Democratic Republic of the
Congo. Over one month into the response, further spread of EVD has
largely been contained. However, in spite of the progress made, there
should be no room for laxity and complacency until the outbreak is
controlled. The focus of the response remains on intensive surveillance,
including active case finding, investigation of suspected cases and
alerts and contact tracing.

On 20 June 2018, four new suspected EVD cases were reported in Iboko
(2) and Bikoro (2) health zones. Four laboratory specimens (from
suspected cases reported previously) tested negative. Since 17 May 2018,
no new confirmed EVD cases have been reported in Bikoro and Wangata
health zones, while the last confirmed case- patient in Iboko Health
Zone developed symptoms on 2 June 2018, was confirmed on 6 June 2018 and
died on 9 June 2018.

Since the beginning of the outbreak (on 4 April 2018), a total of 61
EVD cases and 28 deaths have been reported, as of 20 June 2018. Of the
61 cases, 38 have been laboratory confirmed, 14 were probable cases
(deaths for which it was not possible to collect laboratory specimens
for testing) and nine were suspected cases. Of the 52 confirmed and
probable cases, 28 died – giving a case fatality rate of 54%.
Twenty-seven (52%) confirmed and probable cases were from Iboko,
followed by 21 (40%) from Bikoro and four (8%) from Wangata health
zones. Five healthcare workers have been affected, with four confirmed
cases and two deaths.

The number of contacts requiring follow-up is progressively
decreasing, with a total of 1 527 contacts having completed the
mandatory 21-day follow-up period. As of 20 June 2018, 179 contacts were
under follow up and all (100%) were reached on the reporting date.

The ridiculously complex URL for the following report, even when transcribed correctly, still does not work, exemplifying the dangers when communicating during an epidemic. The reader must scroll down to retrieve it:

What this means for the DRC is that two species of Marburg virus were circulating there in 2000 and the total deaths form them have never been published. Thus, the first-ever report of filoviruses being sequestered in the sexual glands was from the Marburg case in Kenya in 1980.

Posted By: MikeL
Date Posted: June 25 2018 at 9:24am

The ebola report for West Africa, above, is not the originally-shown URL. According to Promedmail, 843 have been vaccinated at Mbandaka (Coquilhatville), 779 at Bikoro, 1518 at Iboko, 107 at Ingende, and 21 at Kinshasa. There are polio and HIV/AIDS links to Mbandaka and Kinshasa.

Posted By: MikeL
Date Posted: June 26 2018 at 10:36am

For polio and ebola vaccination histories at Mbandaka, the link is to Niemann-Pick which is also the link to Koprowski's oral polio vaccine and Poland, as well as cerebral spinal fluid taken from chimpanzees at Lindi Camp. Both polio and Niemann-Pick are mentioned in this report:

VSV-EBOV was the vaccine used at Mbandaka (843 vacinees), recalling that anti-ebola brincidofovir is an ether lipid analogue of cidofovir. Indeed, in Nieman-Pick disease patients have either a zero or low esterification profile, and in alcoholism, ester bonds are changed to ether bonds in cell walls.

At a certain point, the mechanisms involved become less clear, and names of compounds will change to number names, as in this report from Harvard:

(Ap 2016) VSV / Lysosomal / ZCL278

http://www.ncbi.nlm.nih.gov/pubmed/26912630

'....VSV....lysosomal....'

Posted By: Technophobe
Date Posted: June 27 2018 at 12:59am

["Contained" is old news but there have been no new cases sonce the 6th of June.]

Ebola Outbreak in Democratic Republic Congo is ‘largely contained’: WHO

26 June 2018

Almost two months after the start of the latest http://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease" rel="nofollow - Ebola
outbreak in the Democratic Republic of Congo (DRC), United Nations
health experts announced on Tuesday that the deadly disease has “largely
been contained”.

A
total of 55 cases of Ebola have been recorded during the current
outbreak of the often-deadly viral infection and 28 people have died,
according to the http://www.who.int/en/" rel="nofollow - World Health Organization ( http://www.who.int/" rel="nofollow - WHO ).

Ebola is endemic in DRC and has been identified there nine times,
since 1976. Before the current outbreak in Equateur Province, the most
recent episode of the disease was in 2017, in northern Likati province.
Four people died and four survived, according to WHO.

Spokesperson Tarik Jasarevic said that the development was an “important step” but “it is not the end”.

Experience has shown us that it only takes one case to set off a fast-moving outbreak - Tarik Jasarevic (WHO)

“We are cautiously confident regarding the situation and know that a
continued aggressive response is required,” he said, adding that
“experience has shown us that it only takes one case to set off a
fast-moving outbreak.”

Ahead of the WHO announcement, there were fears that the disease
might continue its spread from rural north-western DRC, along the key
Congo River transport route, to the capital Kinshasa, which is home to
10 million people; and also spread to neighbouring countries.

Those concerns were based on the grim toll and progress of the Ebola
epidemic in West Africa between 2013 and 2016, which killed more than
11,000 people in Guinea, Liberia and Sierra Leone.

To counter the threat from the current outbreak – and making use of a
new vaccine - the UN agency and Doctors Without Frontiers (MSF) quickly
coordinated over an inoculation programme that began in the DRC city of
Mbandaka, where around one million people live.

This was followed by another round of preventive vaccination in and
around the town of Bikoro to the south, where the initial Ebola victims
were identified.

According to WHO, the last confirmed case of Ebola in DRC was on 6 June.

Since then, all probable and suspect cases have been declared negative.

A key tactic used to counter the spread of the haemorrhagic disease has been contact-tracing.

During this current episode, WHO and MSF have traced contacts of
those who are suspected of having the disease, administering more than
3,200 vaccinations.

The last 161 people to have come into contact with suspected Ebola
virus carriers will finish their mandatory follow-up period on 27 June,
at which point they will be declared virus-free, WHO says.

Meanwhile, on the ground in DRC, health teams are following as many
as 20 suspect cases a day, said Mr Jasarevic: “We need to keep the work
going in DRC to make sure that all suspect cases are being looked for
and make sure that there are no new cases.”

Filoviruses were discovered in 1967, and yet no proof is extant that bats are infected with the virus. If such a report exists, we'd like to see it displayed on this thread because Africans believing that bats have something to do with the epidemic are as yet a fairy tale. What is the precise reservoir and vector? Nature is not opposed to invention, invention being part of nature itself. Nature is opposed to myth.

Posted By: MikeL
Date Posted: June 27 2018 at 9:01am

Because Mononegavirales sequences have been found in the genome of the soybean cyst nematode (Heterodera), the trajectory links to Australia and by default, a possible explanation for the origins of the Reston ebola virus (Phillipines):

Because VSV-EBOV vaccine is Diptera-based, the investigative trajectory includes bat-flies as ectoparasites of fruit bats.

'Family Hippoboscidae....Wings either normally developed with 6 or 7 longitudinal veins and alula, or reduced and nonfunctional in Hippoboscinae; wings and halter absent in Melophagus.... Obligate blood-sucking ectoparasites of birds and mammals. Reproduction by adenotropic viviparity. The mature larvae (third instar) are usually deposited away from the host and very soon transform into puparia; though in Melophagus they are laid and pupate in the host's hair.

Good! That could mean a bit of real justice for poachers and illegal loggers.

-------------Absence of proof is not proof of absence.

Posted By: MikeL
Date Posted: June 27 2018 at 11:50am

Linking the Hippoboscidae to orangutans also means Pongids co-existing with hominids in Ethiopia, which has been documented. Following the Marburg virus evidence links to Edward Hooper's mention of chimpanzee skulls being sent to the museum in Turvuren(see The River: A Journey to the Source of HIV and AIDS).

If not mistaken, cormorants on Lake Naivasha would link to the Marburg-infected electrician who fed crows and other birds at his home. Hippoboscidae links to crows and bats:

'Family Nycteribiidae....Blood-sucking ectoparasites of Chiroptera with adenotropic vivparity. Females bear third instar larvae away from the host, in the neighbourhood of the roosting place; larva is pressed to the substrate, pupation follows immediately. Female larviparous, returning to the host. Emerged imago without ptilinum, puparial operculum opened by the action of the first pair of legs. After hardening the insect searches for its host.

(Çatalogue of Palaerctic Diptera, p. 227)

Posted By: MikeL
Date Posted: June 27 2018 at 12:13pm

There is a link to Kashmir, West Sumatra, and the Rothschild collection:

Both N. allotopa mikado and N. dentata were discovered the year of the Marburg virus outbreak in Germany, though the Germans would find out that the Marburg agent was circulating in Uganda as early as 1961.

Posted By: MikeL
Date Posted: June 27 2018 at 12:49pm

Following the watercourse from Mbandaka (formerly Coquilhatville), the Ruki River flows into the Busira arriving at Bandaka and Boende. Though yet to find it on a map, Mongende is apparently close to Boende.

Posted By: MikeL
Date Posted: June 27 2018 at 1:55pm

We entered 'syozyodo' as a search term at Pubmed. It retrieved a few refs, with Abe,Y as an author both in 1948 and in 2018. Since Abe is a presidential family name, we further pursue this trajectory. A Yahoo search 'syozyodo' retrieves only one reference:

This Ardmoeca species links to A. schoutedeni at Mogende, Belgian Congo. Further, it may parasitize herons, so heron hepatitis would link the evolution of the retroviruses because hepatitis B virus, HIV-1 and HIV-2 have a common ancestor (reverse transcriptase). Tracking the anti-ebola ether-lipid analogue, brincidofovir, and recalling that in Niemann-Pick a cholesterol transporter is critical for filovirus infection, we link a heron virus (first discovered in 1956) in a heron rookery in Japan, reported in the year of the Marburg virus outbreak in Germany:

the link i posted to "hot zone " the book is all about the 1980 french man and a lot more on Ebola ,Marburg even an airbourne subtype

the "hot zone" refers to an island in africa where the monkeys/ apes who were not wanted by the Scientists the old infirm diseased were dumped ,(this was back in the 60's when animals were captured by the thousands and used for experiments) created a "Hot Zone "of viruses

One approach is to have a companion text to the Hot Zone such as Marburg Virus Disease (Martini and Siegert, eds.), because it shows photos such as the "6-shaped" virus morphology, and devotes an entire chapter on Marburg virus hepatitis. As far as is known, Hot Zone does not mention Naivasha, because the Frenchman, being an outdoorsman, was not documented as having visited the lake there, which is an important clue to possible vectors/reservoirs such as cormorants via Hippoboscidae.

Hot Zone has no index, and most assuredly Hooper's The River should be consulted due to especially the map Preston places at the front of the book.

Posted By: MikeL
Date Posted: June 28 2018 at 10:32am

Preston (Hot Zone) p. 265, 'Highway' : 'The road to Mount Elgon heads northwest from Nairobi into the Kenya highlands, climbing through green hills that bump against African skies. It goes through small farms and patches of cedar forest, and then it breaks over a crest of land and seems to leap out into space, into a bowl of yellow haze, which is the Rift Valley. The road descends into the Rift, cutting across wrinkled knees of bluffs, until it hits bottom and unravels on a savanna dotted with acacia trees. It skirts the lakes at the bottom of the Rift and passes through groves of fever trees, yellow-green and glowing in the sun. It is detained in cities that dwell by the lakes, and then it turns westward toward a line of blue hills. a straight, narrow, paved two-lane highway, crowded with smoky overlander trucks gasping up the grade, bound for Uganda and Zaire. The road to Mount Elgon is a segment of the AIDS highway, the Kinshasa Highway, the road that cuts Africa in half, along which the AIDS virus traveled during its breakout from somewhere in the African rain forest to every place on earth.'

Consulting The Atlas of Africa, 1973, Editions Jeune Afrique, we find that the agricultural map between Nairobi and Mt. Elgon shows large plantings of pyrethrum just west of Lake Naivasha, and above that Tobacco plantings encircling Nakuru. The pyrethrum was most likely used as insecticide on the tobacco, so at the time of the Marburg outbreak in Germany in 1967, mutations in viruses were occurring in the Lake Naivasha region, prompting the question of migrating cormorants and African Corax between Nzoia area and Naivasha.

Intriguingly, a more rigorous scrutiny of the trajectory did yield the Japanese encephalitis connection to Syozyodo Cave yesterday, whereas today pyrethrum links to encephalitis and by default, Lake Naivasha:

Ebola and Marburg virus divergence twixt one another critically depended on their hosts during evolution. Preston's passages on crab-eating monkeys:

'The monkey tree usually hangs out over a river, so that they can relieve themselves without littering the ground....and the troops moves out, leaping through trees, searching for fruit.'

(Preston, Hot Zone p.112 Reston)

We are interested in ebola (not Marburg) antibodies in orangutans on Borneo and Sumatra, a close link to Reston ebola virus. Kaeng Khoi District, Thailand, with Kaeng Khoi being spelled Kaeng Khlo on Macmillan's Book of the World map. It is situated on the Sa Pak River at the edge of a lake.

We next verify that Marburg virus has been fou nd in Egyptian fruit bats, Rousettus aegyptiacus:

Genomic Analysis of Filoviruses Associated with Four Viral Hemorrhagic Fever Outbreaks in Uganda and the Democratic Republic of the Congo in 2012, Virology (2013) 442:87-100: '....Indeed, MARV and RAVN viruses have been repeatedly isolated from common African fruit bats, Rousettus aegyptiacus.'

Evolutionary History of Indian Ocean Nycteribiid Bat Flies Mirroring the Ecology of Their Hosts

Marburg-infected Rousettus aegyptiacus is also infected with other viruses, and it would be patently absurd to suggest that no blood-sucking bat flies never ingested Marburg virus, the corresponding mechanism would mirror Yersinia pestis plague which is endemic on Madagascar.

In developing a Japanese alphabet for use in science and medicine, especially epidemiology, an introductory music video for the alphabet seems worth considering. For example, saxophonist John Coltrane, who died of hepatitis B-caused hepatocellular carcinoma at 41 years of age in 1967, the year of the Marburg virus outbreak in Germany. Ideally, we would ask if Grace Kelly would be interested in being featured in the video. Grace's work appears on the new Manhattan Transfer's album, The Junction, since the passing of founding member, Tim Hauser. Some great musicians are linked to the loss of 461 years of talent due to disease:

The Lost Years: The Impact of Cirrhosis on the History of Jazz (Canadian Journal of Gastroenterology)

europe.pmc.org/articles/PMC2721805

'....Hepatitis B vaccination could improve longevity, but alcoholism and Hepatitis C remain major health issues among jazz musicians.....Hepatocellular carcinoma also claimed major saxophone stylists Stan Getz....and Steve Lacy....It is interesting to speculate where jazz may have gone had John Coltrane and Charlie Parker lived into their 80s rather than succumb to the ravages of liver disease in their 30s. If we assume an average life span 75 years for an adult man, the jazz musicians depicted in Figure 1 have lost a combined 461 years of jazz productivity as a consequence of cirrhosis.'

At the onset of the ebola crisis of 2014, we saw ebola rap emerge from Africa: Ebola in Town "Dont Touch Your Friend."

Stan Getz, who once described himself as "a pale Lester Young," also had this to say:

"There wasn't much choice, I wanted to be a doctor, actually. I think I would have made a good research doctor, with my curiosity."

MikeL recalls attempts to mimick Getz's horn by listening to the Hi-Fi record, which machine was cranking out the music off-key, introducing strange new worlds such as concert C#, F#, B, A flat, etc. Needless to say, the new Japanese alphabet will also be used to score music, at least in MikeL's studio.

The Ministry of Health and WHO continue to closely monitor the
outbreak of Ebola virus disease (EVD) in the Democratic Republic of the
Congo. On 27 June 2018, all the people who were exposed to the last
confirmed EVD case-patient completed their mandatory 21-day follow up
without developing symptoms. This is an important milestone. The last
confirmed EVD case in Equateur Province was cured and discharged from
the Ebola treatment centre (ETC), following two negative tests on serial
laboratory specimens, on 12 June 2018. The response is now focused on
intensive surveillance, including active case finding and investigation
of suspected cases and alerts.

Since our last report on 26 June 2018 (External Situation report 13),
13 suspected EVD cases were reported in Bikoro (10), Iboko (2) and
Wangata (1) health zones. Of the 13 suspected cases, 11 tested negative,
while two suspected cases reported on 30 June 2018 are awaiting
collection of the second specimens for a repeat test after the first
specimens tested negative.

Since the beginning of the outbreak (on 4 April 2018), a total of 55
EVD cases and 29 deaths have been reported, as of 1 July 2018. Of the 55
cases, 38 have been laboratory confirmed, 15 were probable cases
(deaths for which it was not possible to collect laboratory specimens
for testing) and two were suspected cases. One community death that
occurred on 20 May 2018 in Iboko Health Zone was retrospectively
identified and reclassified as a probable case, increasing the number of
probable cases from 14 to 15. Of the 53 confirmed and probable cases,
29 died, giving a case fatality rate of 54.7%. Twenty-eight (53%)
confirmed and probable cases were from Iboko, followed by 21 (40%) from
Bikoro and four (8%) from Wangata health zones. Five healthcare workers
have been affected, with four confirmed cases and two deaths. A total 24
casepatients with confirmed EVD have been cured since the onset of the
outbreak.

Context

On 8 May 2018, the Ministry of Health of the Democratic Republic of
the Congo notified WHO of an EVD outbreak in Bikoro Health Zone,
Equateur Province. The event was initially reported on 3 May 2018 by the
Provincial Health Division of Equateur when a cluster of 21 cases of an
undiagnosed illness, involving 17 community deaths, occurred in
Ikoko-Impenge health area. A team from the Ministry of Health, supported
by WHO and Médecins Sans Frontières (MSF), visited Ikoko-Impenge health
area on 5 May 2018 and found five case-patients, two of whom were
admitted in Bikoro General Hospital and three were in the health centre
in Ikoko-Impenge. Samples were taken from each of the five cases and
sent for analysis at the Institute National de Recherche Biomédicale
(INRB), Kinshasa on 6 May 2018. Of these, two tested positive for Ebola
virus, Zaire ebolavirus species, by reverse transcription polymerase
chain reaction (RT-PCR) on 7 May 2018, and the outbreak was officially
declared on 8 May 2018. The index case in this outbreak has not yet been
identified and epidemiologic investigations are ongoing, including
laboratory testing. This is the ninth EVD outbreak in the Democratic
Republic of the Congo over the last four decades, with the most recent
one occurring in May 2017. Further information on past outbreaks is
available at: http://www.who.int/ebola/historical-outbreaksdrc/en/" rel="nofollow - http://www.who.int/ebola/historical-outbreaksdrc/en/ .